TDRRS Membership Form (2010)
TDRRS Membership Form (2010)
Applicant Details: PLEASE PRINT CLEARLY IN UPPER CASE
Last Name: _______________________ First Name: ___________________ Init: __
Mailing Address: _________________________________________________________
City: _________________ Prov: ____________________ Postal Code: ___________
Tel: (Home): _______________(Bus): _______________ (Mobile)_________________
E-mail Address(s): ___________________________________________________________
DOB (YYYY/MM/DD): __________________ Age____ Male: ____ Female: _____
Have you refereed rugby before? Please circle - Yes or No. If yes, please fill in the following:
2009 Branch Society: ____________________Grade Attained: ____________
Last IRB Course Completed: ___________ Date Completed: ________________
Type of Membership Required (Circle one category and fees to be paid):
|
TDRRS Referee Category
|
Society Fees for Referees Registering thru their Rugby Club
|
Society Fees for Referees Registering thru TDRRS (includes RC/RO fees)
|
Note: Club Registered Referees only pay the TDRRS fees. Their Rugby Canada/Rugby Ontario insurance fees are paid through their club.
|
|
Graded List
|
$95
|
$230
|
For referees who are being actively coached and assessed for status within the Society and possible advancement to Provincial/National Referee Panels.
|
|
Probationer List
|
$60
|
$195
|
For new, inexperienced first year members. These referees are expected to advance to the Graded list.
|
|
Student List
|
$60
|
$195
|
For members who are students and who wish to be active referees.
|
|
Directors’ List
|
$60
|
$195
|
For senior referees, over 45 years of age and a Society member for 5 years, who no longer wish to be graded but who are willing and able to accept appointments.
|
|
Referee Coaches
|
$60
|
$195
|
For those members who actively coach referees on the Graded List.
|
|
Life
|
$0
|
$135
|
Life members designated by the Society who intend to remain active in refereeing. Dues only cover Rugby Ontario/Rugby Canada fees. No Society dues paid.
|
|
Club List
|
$25
|
N/A
|
For referees who are already registered as a player with their club and who intend to officiate only when an appointed referee is unavailable for their own club’s scheduled home games. Generally referred to as Club Referees or casual non-graded referees.
|
Applicant Declaration:
I declare that: 1) the information as supplied above is true and correct.
2) I am not prohibited from participating in the sport of rugby.
Applicant Signature: _______________________ Date Signed: ___________________
|