2025 Coach Registration 2025 Coach & Referee Registration Please complete the below form: Coach InformationCoach Name* First Last Gender*FemaleMaleAge*Date of Birth* Day Month Year Email* Enter Email Confirm Email Parent Email* (required if Coach is under 18 years of age)* Enter Email Confirm Email Mobile*Address* Address Suburb/Town Post Code Which local government do you reside in?* City of Canning Town of East Fremantle City of Melville City of South Perth Town of Victoria Park Are you a new or returning Coach?* New to the Club Coached previously What program(s) will you be coaching in 2025?*WAVL State LeagueWAVL DivisionsJunior LeagueReds BeachParticipation programsWorking With Children Check - NumberPlease enter your Working With Children Check (WWCC) Number.Working With Children Check - ExpiryPlease enter your Working With Children Check (WWCC) expiry date.Referee Accreditation Level* Level 1 Level 2 Level 3 No Accreditation Coach Accreditation Level* Level 1 Level 2 Level 3 No Accreditation First Aid Training*Have you completed First Aid Training through St. John Ambulance or another organisation? Yes No Medical ConditionsPlease detail in the section below any medical history that you would like the Association aware of (eg. allergies, asthma, epilepsy, heart condition, pre-existing or recurring injuries that require monitoring, or any other medical matter that requires the Association’s attention).Planned Absence*Are you planning to be away at anytime this year which may impact your coaching responsibilities? Yes No Please provide the details of your Planned Absence*Emergency ContactName First Last Email MobilePayment of Honorarium Details, if applicablePlease provide the following bank account details to allow the Reds to transfer your honorarium at the end of the season. PLEASE DOUBLE CHECK ALL DETAILS TO ENSURE THEY ARE CORRECTAccount NamePLEASE DOUBLE CHECK ALL DETAILS TO ENSURE THEY ARE CORRECTBSBPLEASE DOUBLE CHECK ALL DETAILS TO ENSURE THEY ARE CORRECTAccount NumberPLEASE DOUBLE CHECK ALL DETAILS TO ENSURE THEY ARE CORRECTPlease complete the Statement by a Supplier form at the link below. Please complete Sections A and B of the form and tick the statement that is mentioned below in Part 3 of the form. This will allow the Club to pay you for work that you consider as a “private recreational pursuit or hobby.” “The supplier is an individual and has given the payer a written statement to the effect that the supply is either: made in the course or furtherance of an activity done as a private recreational pursuit or hobby.” Download Statement by a Supplier Form Please upload the completed document below. Upload completed Statement by Supplier hereMax. file size: 256 MB.Association and Club RequirementsPolicies*I agree to comply with all Association and Club policies. Yes Reds Membership Agreement*I have read and agree to comply with the Reds Membership Agreement. Yes Associate Member* Yes I understand that by completing this membership I will become an Associate Member of the Perth Reds Volleyball Association and either the Reds Volleyball Club or Reds Junior Volleyball Club (dependant on the team).
