Referee, Umpire or Coach Payment Form

Referee, Umpire or Coach Payment Form
Please complete this form to pay a referee, umpire or coach for an activity.

The must be completed at your activity or event. Here's how to complete the form.

1. Open this form on your phone.

2. Hand your phone to the referee or umpire and they complete Section 1.

3. You complete Section 2 and press Submit.

If your payment is more than £30 you will need a second committee member to authorise the payment.

Payments are normally made within 3 working days once the form has been submitted and second authorisation (if needed) is completed.
1. Referee, Umpire or Coach Details

To be completed by the referee, umpire or coach.
Name of Referee, Umpire or Coach*

First NameLast Name
Bank Sort Code*
Bank Account Number*
Date of Activity*
I confirm that I was the referee, coach or umpire on the date above and I am to be paid the fee shown below.*

CONFIRM
Amount to be paid*
2. Sports Club Details

To be completed by club committee member.
Your Club*
Your Name*

First NameLast Name
Your Committee Position*
Your Email*
example@example.com
Email address of the Committee Member for the Second Authorisation Signature, for payments over £30.
Second Signature Email*
example@example.com
I confirm that the referee, coach or umpire should be paid the amount shown above.*

CONFIRM
Privacy Notice

Information on how we manage your personal information can be found on: www.GCUstudents.co.uk/privacy-policy.
Should be Empty:

1. Referee, Umpire or Coach Details