REFEREE SERVICES ORDER FORM

To be submitted at least 10 working days prior to event.

Organisation/School
Contact Name
Postal Address Postal Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email
Mobile Number
EVENT:
Event/League Name
Division
Gender

Gender Male Female
ADMINISTRATION FEES:
Hills Basketball Association charges an administration fee for organising and training officials. An invoice will be emailed to your organisation at the completion of the event.
OFFICIAL FEES:
Please select the type of game/rate of pay. Officials are to be paid CASH at the completion of game.
Number of officials per game
Number of Games
SUPERVISOR FEES:
Please advise if your would like a Referee Supervisor provided for your event. Supervisor to be paid CASH at the conclusion of event.
EVENT VENUE:
Event Venue
Address
Type of venue - Indoor or Outdoor
NB Outdoor venues - In wet weather officials will assess the conditions of the court and if deemed unsafe will contact the Hills Basketball Association Referee Development Officer. Hills Basketball Association reserves the right to make the final decision on referee participation.
EVENT DATE/TIME:
Event Date Event Date / DD / MM YYYY
Event Game Time:
Multiple Date Event details:
Please attach a copy of the draw for multiple games.

Attach Files
AGREEMENT:

1. On behalf of the above organisation , I agree to pay all fees as outlined above.
2. Official fees are non negotiable and may not be withheld for any reason.
3. Where any fixture is cancelled by your organisation or a fixture does not proced without 48 hours notice, the above fees shall still be payable in full.
4. No guarantees of service or quality are stated or implied by Hills Basketball Association.
5. Hills Basketball Association reserves the right to seek assistance from other parties affiliated with a governing body of sport in fulfilling its obligations under this agreement.
Please sign below:

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / DD / MM YYYY

REFEREE SERVICES ORDER FORM

REFEREE SERVICES ORDER FORM

EVENT:

EVENT VENUE:

EVENT DATE/TIME:

AGREEMENT: