Request for Judges Illinois USA Gymnastics

This form is due September 7th.  You must also mail the check to the Assignor.

North Assignor                                       South Assignor
Mary Lou Ackman                                    Billie Stone
1939 Butler Drive                                      1354 Forrest Drive
Bartlett, IL 60103                                      Metamora, IL 61548
630.497.0586                                           309.807.5683

All Assigning Fees Must Be Mailed to Assignor when form is submitted
Assigning Fees $3.00 Per Judge Requested. Checks Payable to: IL-NAWGJ

USA Gymnastics Sanctioned Meet:Yes No     Date:

Hosting Club: Phone:Email:

Name of Meet:Location (address)City:

Report Time for Judges:Start time of Sessions:

Level of Meet:Number of Judges requested:

No. of DaysSession/Day:Approx.No of Gymnasts

Estimated Length of Sessions:Finals:Yes No

Meet Director:Pro No.Email:

Address:City:State:Zip:

Phone: HomeCell:Work:

I have read and understand that the terms and conditions of the Judges employment are governed by the competition agreement, which has been approved by USA Gymnastics as part of their sanctioning procedure.

All Judges and assigning officials must be notified 7 days prior to the meet if there are changes in this contract.
A minimum of 7 days notice is required for cancellations of officials.  Failure to comply will result in payment
 by the meet director of one session per judge and non-refundable expenses incurred.

Submitted by:   Date:

Reminder this form must also be filled out for State Series Meets