Umpire Registration Form

First Name(*)

Invalid Input

Surname(*)

Invalid Input

DOB(*)

Invalid Input

Email(*)

Invalid Input

Mobile Phone(*)

Invalid Input

2022 Club / Team(*)

Invalid Input

--- REGISTRATION ---

All umpires must register as an "Official" with the BNA competition via NetballConnect (even if also registered as a player / coach)

Registered?(*)

Yes

No, please send me the link to register

Invalid Input

--- UMPIRING ACCREDITATION ---

Theory Exam - Year completed (*)

Invalid Input

Theory Mark %

Invalid Input

Foundation Course - Year completed(*)

Invalid Input

Badge level

A

B

C

N/A

Invalid Input

--- UMPIRING OPTIONS ---

Options- select which apply to you

New Trainee - new to umpiring > umpire early games with a Mentor

Consolidating - have experience but not badged > umpire any time without a Mentor

Badge Trainee - would like to train for a C badge > umpire 2 SENIOR games / wk

Badged Umpire - have a minimum C badge > umpire any time

Mentor of NEW trainees - must be badged

Mentor of BADGE trainees - to be ratified by Meg

Badge Tester - must have attended Netball Victoria Testers meeting

Invalid Input

--- UMPIRE PAYMENTS ---

Account Name(*)

Invalid Input

BSB Number(*)

Invalid Input

Account Number(*)

Invalid Input

--- DECLARATION OF HOBBY ---

"For payments in excess of $50, made by Boroondara Netball Association for a service, where an ABN is not provided for taxation purposes. If this form is not signed and an ABN not provided, we are obliged by law to withhold 48.5% for the Tax Office. Please note : It is an offence to make a false or misleading statement".

I hereby declare that the supply (service) is made to the Boroondara Netball Association in my capacity as an individual, and the supply is made in the course of an activity that is a private recreational pursuit or hobby. Therefore, I am not quoting you an ABN. You should not withhold an amount from the payment you make me for the supply. I agree to advise you in writing of circumstances change to the extent that this statement becomes invalid.

(*)

I agree

Invalid Input

Name (Parent/Guardian if under 18)(*)

Invalid Input

Date(*)

Invalid Input