Game Reschedule Form

Must use District 3 rescheduling form.
Must have 14 days reschedule notice. (required submitted form & check to referee scheduler)
$50.00 rescheduling fee - check sent to:
- Beltline Referee Association
  Mike Anderson
  4065 Gettysburg Ave. N.
  New Hope, MN 55427
Reception of confirmation number within 3 days.
After completing the form below press "Submit Form"

Requesting Team (association, level, A,B,C):
Requesting Team Manager:
Requesting Team Manager Email:
Requesting Team Manager Phone:
Reason for Request:
Involved Team (association, level, A,B,C):
Involved Team Manager:
Involved Team Manager Email:
Involved Team Manager Phone:

Rescheduled Game Date (mm/dd/yy):
Rescheduled Game Time:
Rescheduled Game Arena:

Minnesota Hockey District 3