Barossa Carnival Association Referee Nomination Form 2025
Name of Association
*
Association Referee Contact
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
How many referees will you be sending with your teams?
*
Please Select
1
2
3
4
5
6
7
8
9
10
11
12
Referee 1
Referee Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Accreditation Level
*
Please Select
Unaccredited
Level 0 - Green Shirt
Level 0 - Grey / Striped Shirt
Level 1C
Level 1B
Level 1A
Level 2+
Teams Covering
*
Available Saturday
*
Please Select
Yes
No
Available Sunday
*
Please Select
Yes
No
Other carnival involvement (e.g. coaching, playing or following a team) and any additional information
*
Referee 2
Referee Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Accreditation Level
*
Please Select
Unaccredited
Level 0 - Green Shirt
Level 0 - Grey / Striped Shirt
Level 1C
Level 1B
Level 1A
Level 2+
Teams Covering
*
Available Saturday
*
Please Select
Yes
No
Available Sunday
*
Please Select
Yes
No
Other carnival involvement (e.g. coaching, playing or following a team) and any additional information
*
Referee 3
Referee Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Accreditation Level
*
Please Select
Unaccredited
Level 0 - Green Shirt
Level 0 - Grey / Striped Shirt
Level 1C
Level 1B
Level 1A
Level 2+
Teams Covering
*
Available Saturday
*
Please Select
Yes
No
Available Sunday
*
Please Select
Yes
No
Other have carnival involvement (e.g. coaching, playing or following a team) and any additional information
*
Referee 4
Referee Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Accreditation Level
*
Please Select
Unaccredited
Level 0 - Green Shirt
Level 0 - Grey / Striped Shirt
Level 1C
Level 1B
Level 1A
Level 2+
Teams Covering
*
Available Saturday
*
Please Select
Yes
No
Available Sunday
*
Please Select
Yes
No
Other carnival involvement (e.g. coaching, playing or following a team) and any additional information
*
Referee 5
Referee Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Accreditation Level
*
Please Select
Unaccredited
Level 0 - Green Shirt
Level 0 - Grey / Striped Shirt
Level 1C
Level 1B
Level 1A
Level 2+
Teams Covering
*
Available Saturday
*
Please Select
Yes
No
Available Sunday
*
Please Select
Yes
No
Other carnival involvement (e.g. coaching, playing or following a team) and any additional information
*
Referee 6
Referee Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Accreditation Level
*
Please Select
Unaccredited
Level 0 - Green Shirt
Level 0 - Grey / Striped Shirt
Level 1C
Level 1B
Level 1A
Level 2+
Teams Covering
*
Available Saturday
*
Please Select
Yes
No
Available Sunday
*
Please Select
Yes
No
Other carnival involvement (e.g. coaching, playing or following a team) and any additional information
*
Referee 7
Referee Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Accreditation Level
*
Please Select
Unaccredited
Level 0 - Green Shirt
Level 0 - Grey / Striped Shirt
Level 1C
Level 1B
Level 1A
Level 2+
Teams Covering
*
Available Saturday
*
Please Select
Yes
No
Available Sunday
*
Please Select
Yes
No
Other carnival involvement (e.g. coaching, playing or following a team) and any additional information
*
Referee 8
Referee Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Accreditation Level
*
Please Select
Unaccredited
Level 0 - Green Shirt
Level 0 - Grey / Striped Shirt
Level 1C
Level 1B
Level 1A
Level 2+
Teams Covering
*
Available Saturday
*
Please Select
Yes
No
Available Sunday
*
Please Select
Yes
No
Other carnival involvement (e.g. coaching, playing or following a team) and any additional information
*
Referee 9
Referee Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Accreditation Level
*
Please Select
Unaccredited
Level 0 - Green Shirt
Level 0 - Grey / Striped Shirt
Level 1C
Level 1B
Level 1A
Level 2+
Teams Covering
*
Available Saturday
*
Please Select
Yes
No
Available Sunday
*
Please Select
Yes
No
Other carnival involvement (e.g. coaching, playing or following a team) and any additional information
*
Referee 10
Referee Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Accreditation Level
*
Please Select
Unaccredited
Level 0 - Green Shirt
Level 0 - Grey / Striped Shirt
Level 1C
Level 1B
Level 1A
Level 2+
Teams Covering
*
Available Saturday
*
Please Select
Yes
No
Available Sunday
*
Please Select
Yes
No
Other carnival involvement (e.g. coaching, playing or following a team) and any additional information
*
Referee 11
Referee Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Accreditation Level
*
Please Select
Unaccredited
Level 0 - Green Shirt
Level 0 - Grey / Striped Shirt
Level 1C
Level 1B
Level 1A
Level 2+
Teams Covering
*
Available Saturday
*
Please Select
Yes
No
Available Sunday
*
Please Select
Yes
No
Other carnival involvement (e.g. coaching, playing or following a team) and any additional information
*
Referee 12
Referee Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Accreditation Level
*
Please Select
Unaccredited
Level 0 - Green Shirt
Level 0 - Grey / Striped Shirt
Level 1C
Level 1B
Level 1A
Level 2+
Teams Covering
*
Available Saturday
*
Please Select
Yes
No
Available Sunday
*
Please Select
Yes
No
Other carnival involvement (e.g. coaching, playing or following a team) and any additional information
*
Submit
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