2023 Southland Umpires Registration Form
Please complete this form to register as an Umpire for the Southland Wide Club Competition Hockey.

A reminder that ALL umpires must attend at least one of the Season Briefings. These will be notified via email and Hockey Southland and Hockey Southland Umpires Facebook pages

The Winter Club Hockey Season start is March 24th to 26th TBC

If you have any questions around umpiring in Southland please email Emma at hscommunity@hockeysouthland.co.nz

Note: Your availability does not guarantee your appointment to any Local, Regional or National event, this information is simply notifying of your availability in order to prepare for 2023 Hockey season.

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Email *
First Name *
Last Name *
Address *
Cell Phone Number *
Gender *
Date of Birth *
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DD
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Parent Name (if registering umpire U16)
Parent Email Address (if registering umpire U16)
Parent Cell Phone (if registering umpire U16)
What grade/s are you available or interested in umpiring? *
Required
Umpire Mentoring - would you like the support of an umpire mentor? *
Would you be happy to help mentor a junior umpire at times as needed throughout the season? *
Do you have a Hockey NZ Umpiring Qualification? *
Are you interested in gaining a Hockey NZ Umpiring Qualification? *
Please briefly state what you would like help with and what you would like to achieve in umpiring this year *
Please state your size so you can be allocated a Southland Umpires Shirt *
Required
Terms & Conditions *
Required
A copy of your responses will be emailed to the address you provided.
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