2026 Club Allocation Feedback Form
This form needs to be completed by the team captain, and relates ONLY to feedback regarding the umpire supplied by the opposition club. Any feedback provided will only be taken on board if received respectfully.
Feedback must be submitted via this form to be considered. Low ratings without explanation will not be included in any assessment. This is not a complaints process, but a tool to support development and positive behaviours.
Name of Captain Submitting
*
First Name
Last Name
Email (to receive receipt of lodgement)
*
example@example.com
Match Details
Grade
*
Please Select
PLM
PLW
M1M
M1W
M2W
M2M
M3W
M3M
M4W
M4M
M5W
M5M
M6M
M6W
U18M
U18W
U16 Girls
U16 Boys
U14 Girls
U14 Boys
U12 Girls
U12 Boys
U10-U8
Venue
*
Please Select
Adelaide Hockey Club
Adelaide University Hockey Club
Adelaide Hills Hockey Club
Forestville Hockey Club
State Hockey Centre Pitch 1
State Hockey Centre Pitch 2
North East Hockey Club
Port Adelaide District Hockey Club
Seacliff Hockey Club
St Peters College
Woodville
Other
Date of Fixture
*
-
Day
-
Month
Year
Date
Home Club?
*
Away Club?
*
Play the Whistle score.
*
1
2
3
4
5
Name of umpire appointed from the opposing club?
*
Rate the umpire's general ability to control the game (3 is normal, 5 is best). Anything under 3 requires an explanation.
*
1
2
3
4
5
Rate the umpire's ability to communicate decisions (3 is normal, 5 is best). Anything under 3 requires an explanation.
*
1
2
3
4
5
Rate the umpire's professionalism on the field (3 is normal, 5 is best). Anything under 3 requires an explanation.
*
1
2
3
4
5
Comments
*
Submit
Should be Empty: