| LRFOA Inc. Payment Voucher | |||||||
| Check One | |||||||
| ________ | Varsity | __________________ | |||||
| _________ | Junior Varsity | Activity Date | |||||
| _________ | 9th Grade | ||||||
| _________ | Middle School | __________________ | |||||
| Home Team | |||||||
| __________________ | |||||||
| Visiting Team | |||||||
| _________________ | Referee | ||||||
| _________________ | Umpire | ||||||
| _________________ | Line Judge | ||||||
| _________________ | Linesman | ||||||
| _________________ | Back Judge | ||||||
| _________________ | Field Judge | ||||||
| _________________ | Clock Operator | ||||||
| _________________ | |||||||
| Signature of Referee | |||||||
| Complete all information,sign, and return to: | |||||||
| Larry Helton | |||||||
| LRFOA Treasurer | |||||||