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ISKA CANADA –
OFFICIALS REGISTRATION
FORM
International Sport Kickboxing Association – Canada Celebrating 40 Years of ISKA Worldwide
SECTION 1
– PERSONAL INFORMATION
*
*
*
*
*
Gender
*
Gender
Male
Female
Other / Prefer not to say
Mailing
Address
*
*
*
*
Emergency
Contact
*
*
*
SECTION 2
– OFFICIAL CATEGORY (Select all that apply)
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Referee
*
Judge
Timekeeper
Scorekeeper
Ringside Official
Chief Official
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SECTION 3
– CERTIFICATION & EXPERIENCE
Years of
Experience
as Official
*
Previous
Sanctioning
Body (
if any
)
*
Highest
Level
Officiated
*
ISKA
Officials
Course
Completed
*
ISKA Officials Course Completed
Yes
No
Date of
Certification
*
SECTION 4
– REQUIRED DOCUMENTS
■ Criminal Record Check (Vulnerable Sector)
■ ISKA Officials Certification
Upload
Criminal Record
Check
Click to choose a file or drag here
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I will submit it later
Upload
ISKA Certification
Click to choose a file or drag here
I will submit it later
SECTION 5
– DECLARATION
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I confirm that all information provided is accurate.
*
I agree to uphold ISKA Canada rules and regulations.
I agree to follow Safe Sport policies and ethical standards.
Official
Signature
*
Signature
*
Annual
Officials Membership
Fee $40.00
Pay by
e-Transfer
*
Send payment via Interac e‑Transfer to
payments@iskacanada.ca
*
SUBMIT
