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Referees - Mentorship Form
Étape
1
sur
2
50%
Name
*
Prénom
Nom
Date
*
MM slash JJ slash AAAA
Time
*
:
Heures
Minutes
AM
PM
AM/PM
Age Group
*
U10
U11
U12
U13
U14
U15
U16
U17
U18
Current Qualification Level
Entry
Youth
District
Regional
Competition
*
Male
Female
Match
*
eg. Red vs Blue U12 Girls Div 2
Location
*
Match Type
*
Outdoors
Indoor/Dome
Futsol
Referee's Email Address
Saisissez un e-mail
Confirmez l’e-mail
Permission granted to video record this match?
*
Yes
No
Were headsets offered?
*
Yes
No
Were headsets used?
*
Yes
No
Mentor Action Items: Select the appropriate number.
1 = Below Expectations
2 = Meets Expectations
3 = Above Expectations
4 = Well Above Expectations
Aspect 1: Professionalism
On Time
*
1
2
3
4
na
Comments
Appearance (uniform, crest, watch, etc.)
*
1
2
3
4
na
Comments
Perparation (Pre Game Routine, field/equipment checks, knows league rules, etc.)
*
1
2
3
4
na
Comments
Body Language
*
1
2
3
4
na
Comments
Aspect 2: Signals and Whistles
Mechanics (fingers together, thumb tucked in, arm straight, angle of signal, etc.)
*
1
2
3
4
na
Comments
Appropriateness (correct signal done correctly and held long enough.)
*
1
2
3
4
na
Comments
Timing (was a signal needed? Was it done at the right time?)
*
1
2
3
4
na
Comments
Use of whistle (loud enough, long enough, no extra whistles.)
*
1
2
3
4
na
Comments
Aspect 3: Control of the Game
Recognition of fouls (kicks, trips, pushes, handballs, etc.)
*
1
2
3
4
na
Comments
Recognition of elbows or tackles that endanger the safety of an opponent
*
1
2
3
4
na
Comments
Management of injuries
*
1
2
3
4
na
Comments
Aspect 4: Positioning and Movement
Variety of movement during active play (backwards, lateral)
*
1
2
3
4
na
Comments
Position during set plays (DFK, IDFK, GK, CK, KO)
*
1
2
3
4
na
Comments
Physical Fitness and speed
*
1
2
3
4
na
Comments
Angle of view
*
1
2
3
4
na
Comments
Proximity to the play (7 or 16 yds.)
*
1
2
3
4
na
Comments
Aspect 5: Attitude, Rapport & Communication
Relationship with players and coaches (proper respect, strong/clear tone.)
*
1
2
3
4
na
Comments
Reaction to mentorship feedback
*
1
2
3
4
na
Comments
Aspect 6: Procedures
Coin Toss (Question: What direction would you like to attack?)
*
1
2
3
4
na
Comments
Kick Off
*
1
2
3
4
na
Comments
Throw-ins (proper technique, infringemnet recognition.)
*
1
2
3
4
na
Comments
Substitutions
*
1
2
3
4
na
Comments
Aspect 7: Reaction Under Pressure
No overreactions, remains calm
*
1
2
3
4
na
Comments
Demonstration of courage (sticks with decision)
*
1
2
3
4
na
Comments
Ability to take charge (stops play and calls player over to discuss)
*
1
2
3
4
na
Comments
Flow of the game
*
1
2
3
4
na
Comments
Final Thoughts
Keep observations here to a minimum. Please indicate the aspect before comments:
Mentor
*
Prénom
Nom
Signature
*
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