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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Address(*)
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Home Phone
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Mobile Phone(*)
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Team You Play In
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Team(s) you coach
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I am umpiring for (*)
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Do you have 2017 State Membership?
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If not, please register on-line via this website.

--- UMPIRING ACCREDITATION ---
Theory Exam - Year completed (*)
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Theory Mark %(*)
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Level 1 Course - Year completed(*)
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Badge attained

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Year & Venue badge awarded
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--- UMPIRING OPTIONS ---
An umpire availability form will be sent to all registered umpires when fixtures have been finalised.
I am a New Trainee
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I would like to train for a Badge
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I would like to be an Umpire Trainer for

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I would like to be an Umpire Tester
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--- UMPIRE PAYMENTS ---
To be paid at the end of each term unless alternative arrangements have been organised. All payments will be deposited to your nominated bank account (no cash payments)
BSB 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.
(*)

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