Rochester District Basketball Officials

First Name RequiredInvalid Format
Middle Initial Optional Invalid Format
Last Name RequiredInvalid Format
Date of Birth RequiredInvalid Format
--- Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec / --- 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / Role Required
-- Select One -- Official Athletic Director Coach High School Attended Optional Invalid Format
College Attended Optional Invalid Format
Employer Optional RequiredInvalid Format

Address RequiredInvalid Format
City RequiredInvalid Format
State RequiredInvalid Format
ZIP Code RequiredInvalid Format
Phone Number RequiredInvalid Format
Email Address RequiredInvalid Format
Password RequiredInvalid Format
Passwords must contain one lower case letter, one upper case letter, one number, no spaces, and between 6 and 13 characters long. Verify Password RequiredPasswords do not match