Arlington Heights Park District
Referee Rating Form

This form should be filled out and returned with your game report to either your local community Center, the Administration Center (410 N. Arlington Heights Road), or Submit Online. These ratings are used to correct problems during the season, this is especially true with the new and young referees. Please rate the officials FAIRLY and HONESTLY.

Each referee is asked to let the coaches know, before the game their names. Please ask them if they do not let you know.

Team Name:
Field Location:
Game Time:    Date:
Division:
 		 Kindergarten   Div. 1 (Gr. 1)   Div. 2 (Gr. 2)   Div. 3 (Gr. 3-4)
Div. 4 (Gr. 5-6)   Div. 5 (Gr. 7-8)
Did Game Start On Time?   Yes    No
   
Official #1
  Excellent Good Fair Poor
Signals:
Appearance:
Positioning:
Game Control:
Overall Performance:
List Strong Points:
What Needs Improvement:
 
Official #2
  Excellent Good Fair Poor
Signals:
Appearance:
Positioning:
Game Control:
Overall Performance:
List Strong Points:
What Needs Improvement:
Coach's Name   Game Results Won   Lost   Tie
Are you interested in becoming a referee in our program? If so, please leave your address and phone number.
Address    Phone