Referee Registration Form
BAROSSA BASKETBALL BAROSSA VALLEY AMATEUR BASKETBALL ASSOCIATION INC ABN 33490096872 PO BOX 267 NURIOOTPA SA 5355 Message Centre (08) 85633111 Home Page www.barossa.basketball.net.au |
REFEREE REGISTRATION FORM
NAME
ADDRESS
HOME PHONE NO
WORK PHONE NO
MOBILE NO
DATE OF BIRTH / /
REFEREE QUALIFICATION LEVEL LEVEL
MODULES COMPLETED
DATE HIGHEST QUALIFICATION ACHIEVED / /
PREFERRED NIGHTS FOR REFEREEING GAMES
PREFERRED TIMES FOR REFEREEING GAMES
IF YOU ARE A PLAYER, WHAT TEAM AND AGE GROUP?
IF YOU ARE A COACH, WHAT TEAM AND AGE GROUP?
HAVE YOU READ THE BAROSSA BASKETBALL CODE OF BEHAVIOR FOR
OFFICIALS AND THE ASSOCIATION BY-LAWS? YES [ ] NO [ ]
IF NO, PLEASE DO SO. THESE ARE AVAILABLE AT THE WEBSITE www.barossa.basketball.net.au or on request from the RIC. ALL REFEREES ARE REQUIRED TO BE FAMILIAR WITH THESE.
Should your availability or preferences change during the season please let Anita Steinert (85623003) know for Tuesdays, Anne Brown (85621838) for Wednesdays and Thursdays) and (Bob Rochford 85633239) for Mondays.
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