Referee Signup -

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Full Name*

Address*

Street Address Town/City Post Code

Telephone*

Email*

Which league do you want to join?

Do you hold a current and valid safeguarding qualification and certification*

Copies of certificates will be required.

Do you hold current DBS certification?*

Copies of certificates will be required.

Do you hold a current and valid Emergency First Aid at Work qualifications and certification?*

Copies of certificates will be required.

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Certification/Qualifications

Past Experience

Please confirm you are FA Qualified?*

FA FAN Number

Terms*

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I agree for results to be sent to League Manager before 10am morning after fixtures.
I agree for balls to be checked and pumped prior to play.
I agree to keep my FA DBS & Safe guarding up to date while working for Elite Sixes
I agree to give 3 days notice if I can not officiate the fixture of any of the upcoming fixtures in the league.
I agree to return all equipment to Venue if I am no longer able to continue.
I understand that the information I give must be true and accurate to the best of my knowledge.
I understand that any false or incorrect information provided could result in termination or being personally liable.

Signature*