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Request a Clinic

 

Are you a Club, Association, or an Instructor? Do you wish to host a Referee Clinic, Course, or Fitness Test in your area?

Fill out the form below and submit your request. It will be sent to the State Director of Instruction (SDI), R. C. (Chip) Walaska, at RCWalaskaSDI@gmail.com. All areas of the form must be filled out unless indicated otherwise.

IMPORTANT: After you have submitted the Form, please call the SDI at 319-651-7404 to confirm receipt of your clinic request, discuss the particulars of the class, and to get any questions answered.

We will make every attempt to honor requests from Organizations, Clubs, Referee Associations, Assignors or Registered Instructors as the schedule permits. We suggest that you check the Calendar of Events beforehand to see if there are any major conflicts with your date(s), e.g., with the annual Terry Vaughn Referee Academy or with the same clinic, course, or fitness test already scheduled near you, prior to submitting your request.

Most instructor-led Grassroots In-Person Courses last a full day, e.g., 9:00 a.m. to 5:00 p.m. on a Saturday. The Clinic Sponsor will need to provide a Classroom with tables and chairs and a field or area where on-field exercises can be held. The Classroom may also need a blackboard / white board or flip chart easel and paper. The Instructor may require a Projector and Screen for PowerPoint presentation / slide projection. The Clinic Sponsor is responsible for recruiting students and a Club Representative must be on site during the class.

NOTE: The Clinic Sponsor must guarantee at least 10 paid participants. If not, the Clinic Sponsor must make up the cost difference.

 

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6200 Aurora Ave., Suite 607E
Urbandale, IA 50322
Tel: 515.252.6363

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