Water Polo Officials Assignment Request Form

Home Team Information
Home Team Contact Name *
Home Team Email *
Home Team Cell Phone *
Home Team School *
Visiting Team Information
Visiting Team Contact Name *
Visiting Team Email *
Visiting Team Cell Phone *
Visiting Team School *
Game/Match Information
Is this a Boys or Girls Water Polo Game? *
Type of Game *
Venue Name *
Venue Address *
Date (mm/dd/yy)*

Enter the date in the mm/dd/yy format.
Time *
Additional Notes on the Game or Match

Any additional information on the game or match?
Payer Information
Person or site responsible for paying officials for this game
Title *

School/District *
First Name *

Last Name *
Email *

Phone Number *
Officiating Preferences *

The following information must be agreed upon by BOTH coaches.
Chapter Agreed Upon by BOTH Coaches (if any) None AustinDallas-Fort WorthNorth HoustonRio Grande ValleySan AntonioSouth Houston
Chapters You Want UIL to Choose From AustinDallas-Fort WorthNorth HoustonRio Grande ValleySan AntonioSouth Houston
Chapters Schools Want to Scratch AustinDallas-Fort WorthNorth HoustonRio Grande ValleySan AntonioSouth Houston
Crew Preferences No one who has called for either school this year
Crew Size *
Additional crew notes or other specific requests

Any additional crew information?
Both coaches will receive an email receipt verifying this information. If you do not receive a receipt, please check your junk-mail folder or ask your IT department to make sure email from officials@uiltexas.org is not being blocked as junk mail.