Referee & Bench Official Starter Form

Name *

First

Last

Email *

Mobile Phone *

Address including suburb and postcode *

Date of birth *

Working With Children Check - Completed checks only, no application numbers *

Emergency Contact Name *

Emergency Contact Mobile Phone *

Account Name *

BSB *

Account Number *

Confirm BSB *

Confirm Account Number *

I have received a Statement by Supplier form and am aware I must will complete and return the form in order to complete onboaring and receive payment. *

The U League has a duty of care to all those associated with our organisation and to the individuals and organisations to whom our Member Protection Policy applies. It is a requirement of our Member Protection Policy, that we check the background of each person who works, coaches or has regular unsupervised contact with children and young people under the age of 18 years. I sincerely declare: I do not have any criminal charge pending before the courts. I do not have any criminal convictions or findings of guilt for sexual offences, offences related to children, acts of violence or narcotics. I have not had any disciplinary proceedings brought against me by an employer, sporting organisation or similar body involving child abuse, sexual misconduct or harassment, other forms of harassment, acts of violence, illegal drugs or dishonesty. To my knowledge there is no other matter that The U League may consider to constitute a risk to its members, employees, volunteers, athletes or reputation by engaging me. *

I will notify the President, CEO or Competitions Coordinator of The U League immediately upon becoming aware that any of the matters set out above has changed. *

I acknowledge that I have received, read and understood the contents A.C.N. 624 851 805 PTY LTD – The U League’s Member Protection Policy and will conduct myself in a manner pursuant to this policy.