Member Profile Form

You must complete and SUBMIT this form to register with Sydney West Rugby Referees.

MEMBERSHIP DETAILS

MyRugby ID *

* Indicates required field

Title Prefix *

First Name *

Middle Name *

Surname *

Postal Address *

Suburb / Town *

Postcode *

Home Phone *

Work Phone *

Mobile Phone *

Primary Email *

Alternate Email *

Spouse or Partner's Name *

Parent or Guardian's Full Name *

Home Phone *

Work Phone *

Mobile Phone *

Account name *

BSB Number *

Account Number *

APPOINTMENT RELATED INFORMATION

PART 1

What types of matches are you looking to referee and on what days and at what times are you available on weekends?

Step 1: Check the boxes to indicate your interest in handling the various match types that may be available on weekends. If you’re not available on a particular day or not interested in a particular match type, leave that particular small square box unchecked.

Step 2: If you’ve checked a particular match type but you’re available for only part of that match day, enter the time period you expect to be available in the test box to the right of each section.

Note: When you check a small square box and show nothing in the larger rectangular shaded box to its right you are, in effect, indicating that there are no time restrictions on your availability for that type of match on that day of the week.

District JRU Pathway Rugby — Under 6, 7, 8, 9 *

Saturday

DJRU Availability *

Senior Law Rugby (adult players) *

Saturday

Senior Availability *

Sydney JRU Pathway Rugby — Under 10, 11, 12 *

Friday Evening Sunday

SJRU Pathway Availability *

Sydney JRU Under 19 Rugby — Under 13, 14, 15, 16, 17, 18 *

Friday Evening Sunday

SJRU U19 Availability *

Junior School Pathway Rugby — Under 9, 10, 11, 12 *

Saturday

Junior School Availability *

Senior School Under 19 Rugby — Under 13, 14, 15, 16, Opens *

Saturday

Senior School Availability *

Matters such as your grading tier, experience and skill level, current level of physical fitness and overall ability are also taken into account during the referee appointment process.

PART 2

Do refereeing appointments for you need to take into account the weekend playing commitments of either yourself OR your child or children? *

Yes No

Question 2 Comments *

If you answered YES to Question 2, what weekend team or teams do you have a commitment to as a player, a coach, a manager, a parent, etc.? If your refereeing appointments need to take into account those sorts of commitments, then you must tell us:-
(a) The name of each club and/or school team that you or your children play for on weekends
(b) The age group and grade of each team that you or your children play for on weekends
(c) The days on which each of those weekend teams play (i.e. Friday evening, Saturday, Sunday)
(d) The nature of your involvement with each weekend team (e.g. are you a player, a team coach, a team supporter, an assistant referee, etc.).
Please provide each of the requested details (a), (b), (c) and (d) in the shaded box below. Your response needs to be as detailed as possible. For example, you might say something like “My son plays on Saturday for Oakhill College U.14A and on Sunday for Dural U.14C, a team that I also manage” or you might say something like “I play on Saturday mornings for TKS U.16B”.

PART 3

Some members accept appointments at venues on the north shore or northern beaches or in the inner western, eastern or southern suburbs. Are you available for appointment to grounds outside the area normally serviced by Sydney West RRA? *

Are you available for appointment at your playing venue or your child’s playing venue? *

Yes No

Do you have transport to all playing fields in the area serviced by Sydney West RRA? *

Yes No

Are there other restrictions or limitations on your availability that need to be taken into account during the appointments process? For example, weekend work commitments, planned business trips, holiday travel, school camps and retreats, etc. *

Yes No

If you answered NO, identify the playing fields or venues that you are able to get to. *

If you answered YES, please list all matters that are likely to impact on your availability, together with the relevant date or dates for each such matter. *

IF YOU ARE A STUDENT OR AN APPRENTICE, PLEASE SHOW THE NAME OF THE SCHOOL OR INSTITUTION YOU ATTEND AND THE YEAR OF STUDY THAT YOU’RE UNDERTAKING THIS YEAR (E.G. MUIRFIELD HIGH SCHOOL YEAR 10; GRANVILLE TAFE GRAPHIC DESIGN YEAR 2; WESTERN SYDNEY UNIVERSITY BBUS. 3RD YEAR). *

REFEREE CLOTHING AND EQUIPMENT

It is a NSWRU requirement that clothing they supply be issued only to active and registered members for whom all necessary accreditations and certifications are in place and current. NSWRU defines an “active referee” as one who officiates in a minimum of five matches each year.

All Active Referee Members: Please identify your requirements by checking the appropriate “size boxes” for the various clothing items listed below. Note that some items require an up-front payment.

Acme ‘Thunderer’ Whistle ($15 each)
Red & Yellow Card Set
Sydney West Referees Peaked Cap
Law Book and other printed material

The supply of these items should be arranged direct with our Equipment Officer (visit the Contact page for details).

REQUIRED FOR NEW MEMBERS ONLY

To become an active referee you must first register for and attend an appropriate Rugby Australia course and pass the relevant online exam. Before we can appoint new members to matches, we need to know the course or courses you have attended and which online exams you have passed.

Have you attended any of the following Rugby AU courses? *

Foundations of Rugby Course (Foundation Certificate) Refereeing Kids’ Rugby U8-U12 Course (RKR / Pathway) Assistant Referee Course (Assistant Referee Certificate)

Have you passed any of the following Rugby AU online exams? *

Level 1 OR 2 referee referee law and game management Refereeing Kids’ Rugby law and game management Level 1 assistant referee or level 2 assistant referee law