EDHRA Referee Application (Woolwich Wild)

EDHRA Referee Application

Personal Information

Complete all fields:

Name:^*

Required

Last name, first name

Address: ^*

Required

Home Phone:^*

Required

Example: ###-###-####

Cell Phone:^*

Required

Example: ###-###-####

Email Address:^*

Required

Example: [email protected]

Date of Birth^*

Required

dd/mm/yyyy Must be 14 by December 31st

Experience

Complete all fields.

Years of Experience Refereeing^*

Required

Enter the number of years you have been reffing.

Where did you referee most recently?

If applicable

Current Referee-in-Chief Name

If applicable

Current Referee-in-Chief contact information

Enter email or phone number of your current Referee-in-Chief (if applicable)

Personal Commitments

Please enter details of the times/days that you are NOT available to officiate and any other details around your personal commitments.

Will you be playing with the WGMHA this year?^*

YesNo

Required

Is there any particular day or time, you are not available to officiate?^*

Required

Please enter any day or time of day that are you NOT available to officiate?

Other Commitments^*

Required

Briefly describe other commitments (i.e. work, school, other sports, clubs) you are involved in that will affect your availability to officiate

PLEASE READ CAREFULLY: I acknowledge that as an official for WMHA/WGMHA games, I am not an “employee" of EDHRA, but I provide my services on a freelance basis. I agree to adhere to EDHRA and OMHA Officiating policies. I agree to adhere to these policies and accept that disciplinary action may be imposed for failing to follow policies. Disciplinary action may include fines, suspension and/or dismissal. Injury insurance is provided by Hockey Canada, not WMHA or WGMHA. I understand that HC injury insurance is supplemental insurance for costs that exceed what is covered by OHIP and your personal insurance policies. I agree that WMHA/WGMHA, its Board of Directors, Officiating Committee or Referee /Timekeeper Assignor will not be financially responsible for injuries incurred while officiating in games assigned by EDHRA. I understand that a condition of receiving assignments is my availability and I am required to make my services available for a reasonable amount of time each month when WMHA/WGMHA games are taking place. I understand that I may be required to officiate games early Saturday /Sunday mornings (as early as 7:00 am) on a regular basis.. I understand that games assigned to me during times that I declare as “available” and/or games accepted by me are my responsibility . I accept that excessive cancellations of my assignments may result in disciplinary action. Submission of an application does NOT guarantee an officiating position with EDHRA. Acceptance is also dependent on successful completion of annual Hockey Canada Re-certification. Applications for Officials to the EDHRA will be accepted until September 30, 2024.

I agree to the terms and conditions stated above^*