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Umpiring Official 2024 Season
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Details
Fri 08 Mar 2024 00:00 — Mon 30 Sep 2024 00:00
Ipswich Hockey Complex, 65 Briggs Road, Raceview QLD
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Are you attending this event?
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Basic details
First name*
Last name*
Phone number*
Email address*
Address*
Additional information
Are you a*
Please select...
Senior Umpire (16+)
Junior Umpire (U16)
Date of Birth*
If you are a Junior Umpire (U16), did you umpire club fixtures in 2023
Please select...
Yes
No
If you have not umpired Club Fixtures in 2023 (J2 or J1) did you complete the Umpiring 101 Program in 2023 or earlier
Mobile Number (its not downloading from the above)*
I am a*
Player
Umpire
Coach/Manager
Volunteer
Club*
Bellbowrie
Easts
Hancocks
Norths
Swifts
Thistles
Vets
Wests
Not Applicable
Grade*
A
Reserve
R2
A2
C
D (J1)
E (J2)
Not Applicable
Are you playing in any other association?*
Please select...
Yes
No
If Yes - Where
Current Level of Accreditation*
Please select...
None
Community
Community Advance
Level 1
Level 1 Advanced
Level 2
Other
Expiry Date
Umpiring Experience (outline most recent)*
Max. 255 characters
Do you have a Blue Card (over 18)*
Please select...
Yes
No
Card Number
Expiry Date
Do you required an Umpiring Shirt?*
Please select...
Yes
No
I am over 18, or, if I am under 18, this registration has been filled out by and endorsed by my parent or guardian.*
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