Umpire Application Form
Please answer all relevant questions to apply for an umpiring role in WicklowHC for the season 2022-2023. Parent/guardians should apply on behalf of their children. If you have any questions, please contact admin@wicklowhockeyclub.ie.
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Email *
Full Name Applicant *
Umpiring Qualification *
Other Relevant Hockey Umpiring Qualifications (International)
Umpiring Roles WicklowHC - Select Preferred Group(s)/Position
Yes, I would like to be considered for umpiring
Hockey ID (Intellectual Disabilities, 12+ mixed)
Underage Junior Hockey Mixed
Underage Junior Hockey Girls
Underage Junior Hockey Boys
Senior Ladies
Senior Men
Veterans
Social Senior Hockey (mixed adults)
What is your ambition as an umpire? What would you like to achieve through your umpiring? What supports do you need? *
Safeguarding Children Level 1/Code of Ethics Certified - required if you are 16 years or older *
Safeguarding Children Level 1 Certificate Number - please provide if you have one
Safeguarding Children Level 1 Certificate Date
MM
/
DD
/
YYYY
Garda Vetted - compulsory if you are 16 or older *
Garda Vetting Date Completed
MM
/
DD
/
YYYY
Umpiring Experience - please describe briefly *
I am available to umpire on the following day(s)/time(s)
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Morning
Afternoon
Evening
Date of Birth Applicant - Under 18s must provide DOB
MM
/
DD
/
YYYY
Email Address - please provide number parent/guardian if you are under 18 *
Mobile Phone - please provide number parent/guardian if you are under 18 *
Full Name Parent/Guardian - required if applicant is under 18
Agreement - both boxes must be ticked if you wish to be considered *
Required
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