QLD Umpire Fitness Test Result Form

QLD Umpire Fitness Test Result Form
Umpire Name

First NameLast Name
Umpire's HA Panel (Outdoor)
Umpire's HA Panel (Indoor)
Umpire's FIH Panel (Outdoor, Indoor or Hockey 5s)
Date Fitness Test was completed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Yo-Yo Run result (eg. 17.6)
Cooper's Run result (if approved by HAOAG as an alternate run option)
FIH Umpires - 40m Sprint #1 time (enter result to 1/100 - e.g. 6.22 not 6.2)
FIH Umpires - 40m Sprint #2 time (enter result to 1/100 - e.g. 6.22 not 6.2)
FIH Umpires - 40m Sprint #3 time (enter result to 1/100 - e.g. 6.22 not 6.2)
FIH Umpires - 40m Sprint #4 time (enter result to 1/100 - e.g. 6.22 not 6.2)
FIH Umpires - 40m Sprint #5 time (enter result to 1/100 - e.g. 6.22 not 6.2)
FIH Umpires - 40m Sprint #6 time (enter result to 1/100 - e.g. 6.22 not 6.2)
FIH Umpires - 40m Sprint #7 time **if required (enter result to 1/100 - e.g. 6.22 not 6.2)
QLD Approved Supervisor's name

First NameLast Name
QLD Approved Supervisor's email
example@example.com
Did you video-record the Fitness Test? A copy of the video-recording will be uploaded to the HQ Umpire Fitness Test Google Drive folder for review as requested by HA or HQ.
By submitting this form you declare that this fitness test was witnessed by yourself, as an approved Supervisor and met the requirements as outlined in the FIH Guidelines for Fitness of Umpires document.
Should be Empty: