SA Country Junior Championships U12/16

SA Country Championships U12 / U16 Referee Form

Saturday 25th 2023 - Sunday 26th March 2023
Name*

First NameLast Name
Date of Birth:

DayMonthYear
Mobile number*
Email*
example@example.com
Association*
Are you a Ref Coach?*

YesNo
Available to:

Ref Coach ONLYRef Coach & Referee

Please indicate your availability for Saturday 25th March 2023: (note games may not be scheduled at all these times)*

Please indicate your availability for Sunday 26th March 2023: (note games may not be scheduled at all these times)*

Which venue/s can you referee at during the tournament?

St ClairSpringbankWayvilleThe LightsMarion
Do you currently have a Refbook account?*

YesNo
Have you updated your availability in Refbook to be available for JCCs?*

YesNo
We are using Refbook as our scheduling and payment system for the Country Championships. Please ensure that your bank details are up-to-date in Refbook to allow for prompt payment post tournament.

If you are not on Refbook, please join here: https://live.refbook.com.au/auth/register

You must then email referees@basketballsa.com.au so you can be added to the BSA organisation.
Do you play in a team? If so, which Age group, Team and Division?*
16B3 Yorke Valley or NA
Do you have a sibling playing in a team? If so, which Age group, Team and Division?*
12B1 Mt Gambier or NA
Any information that may assist with scheduling your appointments?
Please indicate your Referee Level:*

Level 0Level 1CLevel 1BLevel 1ALevel 2
DCSI / Working With Children's Check - please provide the following information. Anyone above the age of 14 must have a current valid WWC Check Please note if you are under the age of 14, this section is not required.*
Signature*

Clear
Should be Empty:

SA Country Championships U12 / U16 Referee Form