Lil' Squirts Ocean - Official Nomination Form
Lil' Squirts Ocean Carnival
26 October 2019, Miami Beach SLSC
Please complete the form below to nominate as an official for this carnival.
* Required
Email address
*
Your email
Name
*
Your answer
Club
*
Point Lookout
Coochiemudlo
Southport
Surfers Paradise
Northcliffe
Broadbeach
Kurrawa
Mermaid
Nobbys
Miami
North Burleigh
Burleigh Heads Mowbray Park
Other:
Official Accreditation Level
*
Level 1
Core
Level 2
Technical
Level 3
Senior
Unsure
Official Accreditation Number
*
Your answer
Official Accreditation Expiry Date
*
2019
2020
2021
2022
Blue Card Number
*
Your answer
Blue Card Expiry Date
*
MM
/
DD
/
YYYY
Medical Conditions
Your answer
Dietary Requirements
Vegetarian
Vegan
Gluten-free
Other:
Preferred Officiating Position/s
*
Sectional Referee
Starter
Check Starter
Marshall
Check Marshall
Recorder
Chief Judge
Judge
Course Supervisor (ARRO)
Safety Coordinator
IRB Coordinator
Competitor Liason
Appeals
Other:
Required
Preferred Area to Officiate
*
Not bothered
Other:
Required
A copy of your responses will be emailed to the address you provided.
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