NSF-MSF MINNESOTA OFFICIAL UMPIRE MEMBERSHIP APPLICATION

Instructions: Fill out the registration form below and click Proceed to Checkout at the bottom. Once you have paid, your payment will be confirmed by email.
You may also download this registration form and mail it in with check/money order. APPLICATION FEE IS NON-REFUNDABLE

Name   Address
City  State  Zip
Email
New Renew    # of Years MSF Umpire  County
Primary community you umpire in:
Officials Associations you are a member of (if any)
Please check below disciplines of the sport you umpire:
Youth Slowpitch  Youth Fastpitch   Adult Slowpitch  Adult Fastpitch  Modified Pitch


To be officially registered as a NSF-MSF member umpire you must also attend a rules certification clinic in 2019.

Quantity Product Price
Membership:
To avoid a $3.00 postage and handling fee mail this application to NSF-MSF offices no later than 10 days prior to the clinic date you plan to attend or bring application and fee to clinic you attend.

POSTAGE & HANDLING - $6.00 (Add $6.00 for postage and handling if this application is mailed to MSF offices after you have already attended a clinic. Also, enclose your clinic attendance slip. $6.00
If you provided proof of comparable liability and excess medical insurance from NASO or the MN State High School League that covers all the games you do regardless of affiliation we will refund you $10. (Documentation must be provided at time of registration. You may email us your proof of insurance or postal mail it.)
Additional NSF-MSF Rule Book $7.50 each
NSF-MSF Score/Rulebook Combo $10.00 each
Softball Scorecards (package of 50) $5.50 each
Flipping Coin $3.00 each
Brackets Double Elimination or Three Game Guarantee May be printed at printyourbrackets.com FREE
  Voluntary Contribution of one game fee or more to the Minnesota Softball Hall of Fame $
Total

I herewith make application to register as an umpire with the NSF-MSF of Minnesota and by submitting the membership fee agree to abide by the established rules and regulations which govern member officials. I understand if I umpire games where players 18 & under participate I must undergo concussion training at least every three years at https://www.cdc.gov/headsup/resources/training.html and I acknowledge that I have done so and printed myself a certificate to maintain in my possession. I acknowledge that I act as an independent contractor when entering into an agreement with an NSF-MSF member league/tournament or team and am not entitled to unemployment benefits, workers compensation insurance or social security contributions/benefits. Contractor agrees that failure to provide workers' compensation insurance for himself/herself, spouse, parents, or children constitutes a rejection of workers' compensation benefits for those individuals. Submission of this application acknowledges agreement to above conditions and the additional conditions found in the 2019 membership brochure.
Applicant's e-Signature Date

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