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Registration

First name*

Last name*

DOB*

Day/Month/Year

Email*

Mobile*

e.g., 0400123456

Postcode*

Umpire Discipline*

What age group are you interested in umpiring?*

Where did you hear about becoming an umpire?*

By completing this form you are providing personal information to the WA Football Commission and your information will be used and stored as per our Privacy Policy.

I have read and understand the policy.*