NB-TOC 2024 Referee Registration Form

Nunawading Referee Registration 2024
To register as a referee at Nunawading, please complete the following form.

By completing the form below, you are also giving permission for Nunawading Basketball to pass on your email and phone number to Basketball Victoria and affiliated associations regarding referee information only.

Please ensure if you are over 18 years of age, you have a valid WWC card that you can upload an image of.

If you have any questions please email cav@nunawadingbasketball.com.au
Personal Details
Referee Name*

First NameLast Name
Referee Level*

Trainee (new referee to be trained)ApprenticeC GradeB GradeA Grade (Domestic)A GradeLevel 1Level 2Level 2 (Domestic)Level 3Level 4Level 5
Mobile Phone Number*
E-mail*

Confirmation Email
Registered
Referee Coach Level*

NoneGrade 1Grade 2Grade 3 LeaguesGrade 3 AdvisorGrade 4
Are you going to referee any games on any leagues or domestic this year?

YesNo
Are you going to regularly referee on a domestic shift this year?

YesNo
Are you Under or Over 18 years of age?*

Under 18 years of ageOver 18 years of age
Age
Notes
Gender*

FemaleMaleOther
Date of Birth*

DayMonthYear
Date
Working With Children

Those over 18 years of age must provide a WWC card and details. Please have a photo of your card ready to upload.
Have you previously submitted your WWC details and photo of your card to Nunawading Basketball?*

YesNo
Working With Children Number*
Working With Children Expiry*

DayMonthYear
Please upload a photo of you WWC card here *

Browse Files

Cancelof
Emergency Contact
WWC Linked to Nunawading
Name of Emergency Contact*
Relationship to you*
Mobile Phone Number of Emergency Contact*
Email of Emergency Contact *
Further Information
I give permission for Nunawading Basketball to publish any photos taken*

YesNo
Do you have any medical conditions or allergies Nunawading should be aware of?*

Yes (please list below)No
Please list any medical conditions and allergies
Please add any additional comments here regarding your registration (optional)
First Year Refereeing (this could be somewhere other than Nunawading)*
Number of Years Refereeing
Bank Details

Referees will continue to be paid via bank transfer. Please register your bank details here to ensure we have the most current information on file.
Have you previously provided Nunawading Basketball with your bank account details for reimbursements?*

Yes I haveNo I haven't, and I will provide it via the link below
Please update your bank account details here:

https://form.jotform.co/92270770002851
Nunawading Referee Shop
If you require a referee shirt, jacket or whistle you can purchase them from the online Nunawading Referee Shop Order Form here:

https://form.jotform.co/82798328772878
Nunawading Policies and Procedures
CLICK HERE TO VIEW THE NUNAWADING REFEREE POLICIES AND PROCEDURES
I agree the information provided is correct and I have read and will abide by the rules, policies, by-laws and expectations of Nunawading Basketball and the TOC and to behave in the values of the referee program
Should be Empty:

Nunawading Referee Registration 2024

Personal Details

Working With Children

Emergency Contact

Further Information

Bank Details

Nunawading Referee Shop

Nunawading Policies and Procedures