Umpire Registration Form

First Name(*)

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Surname(*)

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Email(*)

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DOB(*)

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School year level(*)

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Mobile Phone(*)

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2020 Club / Team(*)

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Do you have 2021 Netball Victoria Membership(*)

Yes, as a BNA player / coach

Yes, with another organisation

No, please send me the link to register

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All Umpires must have current Netball Vic State Membership (insurance)

Netball Victoria membership number(*)

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--- UMPIRING ACCREDITATION ---

Theory Exam - Year completed (*)

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Level 1 Course - Year completed(*)

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Badge level

A

B

C

N/A

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Year badge awarded

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--- 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 2020

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On completion of the Umpire Registration Form, please then complete the Umpire Availability Form according to your level above. https://bna.org.au/umpires/roster/umpire-availability

--- UMPIRE PAYMENTS ---

To be paid at the end of each term. All payments will be deposited to your nominated bank account (no cash payments)

Bank Details (*)

SAME as 2020 (no need to re-enter)

NEW account (enter details below)

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Account Name

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BSB Number

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Account Number

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--- 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

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

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Date(*)

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