2014 ASA National

Umpire School
Houston Amateur Softball Association
Registration Form
Name: ___________________________________________________________________
Street Address: ____________________________________________________________
City: ____________________ State: _________________ Zip Code: _________________
Email Address: ____________________________________________________________
Home Phone: (_____) __________________ Cell Phone: (_____) ___________________
Male: ________

Female: ________

Years as ASA Umpire: ________

Age: ______________________

Most recent NUS: ________

ASA National Championships worked: ________ Highest Division Worked:___________

Shirt Size:

XL

XXL

XXXL

Cost per person (not including hotel room): $90 if Cashiers Check
$95 by Credit Card via PayPal
Mail Cashiers Checks to:

Brian Mount
Payable to Houston ASA
Houston ASA
P.O. Box 90248
Houston, TX 77290

Pre-registration will end December 1, 2013. Registration fee after December 1, 2013
will be $110. Space is limited!!!