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Newtown Soccer Club - Referee Payment Form
Travel - Premier
(Fall 2013 Season)
Amount given to coach:   $      
Amount paid to referees:   $      Referees should be paid at halftime.
Amount to be returned:   $      
At the end of the season, please return the signed referee payment form and any unused money (check made out to Newtown Soccer Club), to Newtown Soccer Club, PO Box 193, Newtown, CT 06470
Travel       Premier    
Division Center AR   Division Center AR
U9-U10 $40 25   U12 - U14 $55 35
U11 - U14 $50 35   U15 - U19 $60 40
U15 - U19 $60 40        
Date Referee Name Referee Signature Amount Paid