Nepean Valley Basketball Referee Registration

Full Name

Enter your full legal name.

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DOB

Enter DOB DD/MM/YYYY

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Address

Address Line 1

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Address Line 2

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City

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State

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Postal Code

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Country

Mobile Number

Include your mobile number for contact purposes.

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Email Address

Provide a valid email address.

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Working With Children Check (WWC) Number

Enter your WWC number – or type U18 if under 18.

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Emergency Contact Name

Provide the full name of your emergency contact.

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Emergency Contact Phone

Include the phone number of your emergency contact.

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Current Referee Level

Select your current referee level.

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Years of Experience

Enter your total years of experience officiating.

Preferred Day Availability

Select the days you are available to officiate.

Monday Evening

Tuesday Evening

Wednesday Evening

Thursday Evening

Friday Evening

Saturdays

Sundays

I acknowledge that refereeing is conducted as a hobby activity and that I am responsible for declaring any income earned to the ATO as hobby income.

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I understand that I must complete a PAYG Hobby Declaration form online before officiating.

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I understand that I will need to register with Nepean Valley Basketball prior to being assigned games. (Fee TBA)

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I acknowledge that my payment rate will be confirmed once registration and grading are finalised.

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I confirm I am at least 12 years of age.

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I agree to uphold the Nepean Valley Basketball Code of Conduct and maintain professionalism at all times.

This field is required.