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Officials EOI/Registration - BorderClash Junior Roller Derby Tournament 2026
Sat 10 Oct 2026 7:30AM - Sun 11 Oct 2026 7:30PM
Bendigo Show Grounds - Regional Events Complex, 42–72 Holmes Road, North Bendigo, VIC 3550
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Are you attending this event?
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Basic details
First name*
Last name*
Phone number*
Email address*
Address*
Additional information
Legal Name*
Derby Name*
Pronouns*
She/Her
He/Him
They/Them
She/They
He/They
Other
N/A
Emergency Contact Name*
Emergency Contact Number*
League Affiliation - FULL League Name Please. No Acronyms.*
I Will Be Unavailable During:*
N/A
Level 1
Level 2
Level 3
How Many Games Would You Like To Officiate?*
1
2
3
4
5
6
7
8+
Which Day(s) Would You Like To Officiate?*
Saturday
Sunday
Both
Please Provide An Officiating History.*
Max 255 characters
Crew Head Skating Official*
No Thank You
Newbie
Confident
Expert Level
Inside Pack Referee*
No Thank You
Newbie
Confident
Expert Level
Jammer Referee*
No Thank You
Newbie
Confident
Expert Level
Outside Park Referee*
No Thank You
Newbie
Confident
Expert Level
Crew Head Non-Skating Official*
No Thank You
Newbie
Confident
Expert Level
Jam Timer*
No Thank You
Newbie
Confident
Expert Level
Penalty / Line Up Tracker*
No Thank You
Newbie
Confident
Expert Level
Scoreboard Operator*
No Thank You
Newbie
Confident
Expert Level
Scorekeeper*
No Thank You
Newbie
Confident
Expert Level
Penalty Box Manager*
No Thank You
Newbie
Confident
Expert Level
Penalty Box Timer*
No Thank You
Newbie
Confident
Expert Level
Commentator*
No Thank You
Newbie
Confident
Expert Level
Video / Camera Assistant*
No Thank You
Newbie
Confident
Expert Level
League/Officiating Reference *Please Provide Both Name & Best Contact Info Eg Email Address Or Contact Number*
Max 255 characters
Insurer*
Skate Australia
Skate SA
Skate QLD
Skate NSW
Skate WA
Skate Victoria
Other
Insurance Number
Do You Have Your WWCC?*
Yes
No But I Will Get This
Copy Of WWCC
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5MB
What Are Your Dietary Requirements?*
No Dietary Requirements
Gluten Free
Vegetarian
Vegan
Dairy Free
Allergen
Other
Please Let Us Know If You Have Anything Else To Add!
Max 255 characters
Please Let Us Know If You Require Any Support Or Have Any Medical Conditions That We Need To Know About.
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By Submitting This Expression Of Interest, Do You Confirm That You Have Read & Agree To Abide By Our Junior Policy? Read The Policy Here (You May Need To Copy/Paste Into Your Browser) https://drive.google.com/file/d/1dDHuEoxyrQaCFAILMs | Thank You.*
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I am over 18, or, if I am under 18, this registration has been filled out by and endorsed by my parent or guardian.*
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