Referee Application

Thank you for your interest in becoming a Referee for our Winter Upward Basketball League!  Together, our goal is to provide a fun, positive sports experience for every participant!  Please complete the form below to initiate the application process.

Once your application is submitted and reviewed, you will receive notification and further information regarding becoming a Referee within our league.  If you have questions, please contact the Recreation Office via email or by phone at  804.897.3458.

  • Basketball Referee
First Name
Last Name
  • Male
  • Female
Street Address
ZIP Code
Email Address
Cell Phone Number
Alternate Phone Number
Birthday (XX/XX/XXXX)
Are you a member of a local church?
  • Yes
  • No
If so, which church?
Please select days available to referee. (Games are played on Saturdays).
  • Saturday

Games can run throughout the day and times may depend on the division playing. If certain times will be a problem, please notify us. Games begin Saturday, January 13, and continue through Saturday, March 3, 2018.

Select the game location(s) you are willing to referee (please select all that apply).
  • Crestwood Church
  • Mt. Pisgah United Methodist Church
  • St. Mark's United Methodist Church
Gender to Referee (select all that apply)
  • Boys
  • Girls
Grades to Referee (select all that apply)
  • Kindergarten
  • 1st
  • 2nd
  • 3rd
  • 4th
  • 5th
  • 6th
  • 7th
  • 8th
Referee Shirt Size

Our Upward Basketball League is a sports ministry, which means we employ the use of basketball to teach biblical truth and life-lessons in order to help young athletes develop into life-long followers of Jesus Christ. We teach the sport in an affirming, engaging environment and focus on the development of each participant, no matter their current skill level. If you have questions about these league values, please contact us. The following questions aid in our ability to pair offcials together.

Have you ever been a basketball official in our Upward League?
  • Yes
  • No
What other, if any, recreation programs or leagues do you have experience being an official? Please specify sport(s) as well.
Have you made a personal commitment to Jesus Christ, both recognizing Jesus as Lord and Savior of your life and maintaining a personal relationship with Christ?
  • Yes
  • No
I understand the league values, and I commit to serving as a Christ-like example to the teams, the coaches, fellow officials, and the entire league. I commit to develop my understanding of sports ministry and how to employ the tool of sports in order to nurture and connect players to the life-giving source of Jesus Christ. I recognize that I will serve as an authority on the court.
  • Yes
  • No

Per League Policy, officials must receive a Background Check.

Do you have a current background check? Check all that apply.
  • County Parks & Rec (a copy will be requested)
  • Our Upward League (as previous coach/referee)
  • Other (a copy will be requested)
  • No, please send me details for the background check to be completed.
We can provide on court training for officials. Would you be interested in attending?
  • Yes
  • No
Please include any additional comments you'd like to share for consideration.

I understand that the children and the teams on the court have been placed under my guidance as an official. Further, I understand that any negative personal habits that I have (smoking, alcohol, profanity, etc) may have a negative affect on a child's development. Therefore, I commit to setting a worthy behavioral example for them to look. I commit to treating others with respect (players, parents, volunteers) and will make every effort to encourage any individual involved within this program and will avoid open criticism. I will also make every effort to be thoroughly familiar with the League's basketball rules and procedures, and I commit to follow those rules and procedures. I will commit to ensuring all volunteer duties and responsibilities be fulfilled as outlined by the League. I also understand that it is a League policy to perform a background check on each referee participating in this ministry. I commit to maintaining a working email address, checking it regularly, and will notify the League Administration of a change.

I agree to follow the above guidelines for behavior and participation as an Upward Referee and agree to become familiar with the rules and guidelines of this League (type name to indicate signature).