Referee Name

Referee Name:

USSF ID#:

Game Date:

Game Time:

Game Number:

Coach Name:

Team Name:

Age Group:

Gender:

My Team:

Won Lost Tied

The Referee:

Poor…….…Excellent (select one - 5 Excellent, 1 poor)

A

Knows and understands the laws.

1

2

3

4

5

B

Applies laws accurately and consistently.

1

2

3

4

5

C

Maintains proper positioning.

1

2

3

4

5

D

Assures player safety.

1

2

3

4

5

E

Communicates well with players and coaches

1

2

3

4

5

F

Is decisive and provides appropriate signals.

1

2

3

4

5

G

Handles challenges & difficult situations well

1

2

3

4

5

H

Is poised, dignified & properly attired.

1

2

3

4

5

I

Overall this Referee managed the game well.

1

2

3

4

5