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Fill in Your Pa 611 028 Form

The PA 611 028 form is designed for individuals seeking approval or renewal of their license to officiate professional or amateur combative sports in Washington State. It serves as a certification that the individual has acquired adequate experience, skill, and training from an organization recognized by the Department, as mandated by RCW 67.08.100. This essential document must be submitted annually to the Combative Sports Program, ensuring that officials are qualified to oversee events ranging from boxing to martial arts.

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In the world of combative sports, ensuring the competence and skill level of officials, such as referees and judges, is paramount for the integrity of the sport and safety of its participants. Enter the PA 611 028 form, a crucial document in the State of Washington that serves as a Combative Sports Certification of Official. This form is designed for individuals who are seeking approval or looking to maintain their license as officials in professional or amateur combative sporting events. It requires officials to furnish annual proof of certification, demonstrating they have the requisite experience, skill, and training from an organization recognized by the Department. The comprehensive nature of the form not only covers the certification process but also includes sections for the official to indicate their capacity (e.g., referee, judge, timekeeper, inspector), the type of event they are qualified for (e.g., pro boxing, pro martial arts, amateur mixed martial arts), and the date when their training was completed. Moreover, the form allows for an in-depth assessment of the official's abilities, asking for specific examples of their skills and experiences. Completion of this assessment is then validated by the signature of an authorized representative from a certifying organization, ensuring that the official meets the standards set forth by the Department of Licensing. The PA 611 028 form symbolizes a key step in maintaining the high standards and safety protocols necessary in the dynamic realm of combative sports.

Document Example

Combative Sports Certification of Official

An individual wishing to be approved, or maintain his/her license, shall provide annual proof of certification as having adequate experience, skill, and training from an organization approved by the Department. (RCW 67.08.100)

When completed, send this form to:

Combative Sports Program, Department of Licensing, PO Box 9026, Olympia, WA 98507-9026 or fax to (360) 570-4956

I certify that I have assessed the experience and skill of

Name of individual

and this individual has adequate experience, skill, and training to be licensed in Washington State to perform in the following official capacity for professional or amateur combative sporting events.

Official capacity

Event type

Date training completed

Name of instructor

 

 

 

 

Referee

Pro boxing

 

 

 

 

 

 

 

Pro martial arts

 

 

 

 

 

 

 

Amateur mixed

 

 

 

martial arts

 

 

 

 

 

 

Judge

Pro boxing

 

 

 

 

 

 

 

Pro martial arts

 

 

 

 

 

 

 

Amateur mixed

 

 

 

martial arts

 

 

 

 

 

 

Timekeeper

Pro boxing

 

 

 

 

 

 

 

Pro martial arts

 

 

 

 

 

 

 

Amateur mixed

 

 

 

martial arts

 

 

 

 

 

 

Inspector

Pro boxing

 

 

 

 

 

 

 

Pro martial arts

 

 

 

 

 

 

 

Amateur mixed

 

 

 

martial arts

 

 

 

 

 

 

Describe in detail your assessment of the above individual’s skills, experience, and abilities to perform these duties, and provide specific examples:

PRINT or TYPE Certifying organization name

Address

City

State

ZIP Code

(Area code) Telephone number

PRINT or TYPE Name of authorized representative

Signature of authorized representative

X

Date

PA-611-028 (R/8/13)WA

We are committed to providing equal access to our services. If you need accommodation, please call (360) 664-6644 or TTY (360) 664-0116.

File Data

Fact Detail
Form Name PA 611 028
Purpose Certification of Official for Combative Sports
Governing Law RCW 67.08.100
Submission Details Send to: Combative Sports Program, Department of Licensing, PO Box 9026, Olympia, WA 98507-9026 or fax to (360) 570-4956

Guide to Filling Out Pa 611 028

Getting ready to fill out the PA 611 028 form is a necessary step for those involved in the combative sports community in Washington State seeking to become certified officials. This form is a means to verify an individual's skills and experiences in officiating combative sporting events. It's about ensuring that officials have the requisite knowledge, skill, and training deemed necessary by the Department. Once completed, this form is a ticket to entering or continuing in the role of a referee, judge, timekeeper, or inspector at both professional and amateur levels. The process is straightforward, but attention to detail is key to ensure the application is processed without delay.

  1. Start by clearly printing or typing the name of the individual being certified in the designated space.
  2. Choose the official capacity that you are certifying the individual for. This could be as a referee, judge, timekeeper, or inspector. Select the type of event next to the role, such as professional boxing or amateur mixed martial arts.
  3. Enter the date on which the training for the specified role was completed.
  4. Provide the name of the instructor who conducted the training.
  5. In the section provided, describe in detail the assessment of the individual’s skills, experiences, and abilities relevant to the duties of the appointed official capacity. Include specific examples to support your assessment.
  6. Enter the certifying organization's name that is recognizing the individual’s ability and authority to act in the capacity they are being certified for.
  7. Provide the address, including city, state, and ZIP code, of the certifying organization.
  8. Fill in the organization's telephone number, including the area code.
  9. Clearly print or type the name of the authorized representative completing and certifying the form.
  10. Have the authorized representative sign and date the form.

After the form is completed, it is crucial to double-check all the information entered for accuracy and completeness. The next step is to send the form either via mail to the Combative Sports Program, Department of Licensing, PO Box 9026, Olympia, WA 98507-9026, or fax it to (360) 570-4956. It's also a good practice to keep a copy for your records. Processing this form is the final step in becoming or remaining a certified official for combative sports in Washington State.

Your Questions, Answered

What is the PA 611 028 form?

The PA 611 028 form, titled "Combative Sports Certification of Official," is a crucial document for individuals seeking to obtain or maintain a license as an official in combative sports including professional or amateur boxing, martial arts, and mixed martial arts in Washington State. It serves to verify that an individual possesses adequate experience, skill, and training, as required by the Department of Licensing.

Who needs to fill out this form?

Any individual aspiring to serve as an official in various capacities (referee, judge, timekeeper, inspector) at professional or amateur combative sporting events in Washington State must complete this form. It is also necessary for those seeking to renew their existing licenses to officiate such events.

What information is required on the PA 611 028 form?

The form requires detailed information on the applicant, including their name, the specific official capacity they wish to serve (e.g., referee, judge), the type of event (e.g., pro boxing, amateur martial arts), and the date training was completed. Additionally, it requires the name and signature of an authorized representative from a certifying organization, who can attest to the applicant's skills and experience.

How can someone get certified to fill out this form?

Individuals must obtain certification from an organization approved by the Washington State Department of Licensing. This involves undergoing specific training programs and gaining experience relevant to the official capacity they aspire to fulfill at combative sports events.

Where should this form be sent once completed?

The completed PA 611 028 form should be sent to the Combative Sports Program at the Department of Licensing in Olympia, Washington, either through mail to PO Box 9026, Olympia, WA 98507-9026 or via fax at (360) 570-4956.

Is there a submission deadline for the PA 611 028 form?

The form does not specify a submission deadline; however, it is advisable to submit the form well in advance of any event the applicant wishes to officiate. This ensures there is ample time for processing and any potential follow-up required by the Department of Licensing.

Can this form be submitted electronically?

While the form mentions fax submission as an option, it does not explicitly provide for electronic submission via email or an online platform. For the most current submission options, it's recommended to contact the Combative Sports Program directly.

What happens after the form is submitted?

Upon submission, the Combative Sports Program will review the form to ensure all information is accurate and complete. They may also verify the credentials with the listed certifying organization. If approved, the applicant will receive their license to officiate at combative sports events within Washington State.

Who can one contact for further information about this form?

For additional information or questions regarding the PA 611 028 form or the licensing process, individuals are encouraged to contact the Combative Sports Program by calling (360) 664-6644 or using the TTY number (360) 664-0116 for those who need accommodation.

Common mistakes

Filling out government documents can seem daunting, and when it comes to forms like the PA 611 028, specifically designed for those seeking to be approved or maintain their license in combative sports in Washington State, the stakes are even higher. Mistakes made on this form can delay the process, or worse, result in the denial of certification. Here's a look at some common missteps to avoid.
  1. Not providing detailed assessment of the individual's skills, experience, and abilities. The form requires a thorough evaluation, yet often submissions are vague or lack specific examples that highlight the individual's competence in their chosen capacity, whether that be as a referee, judge, timekeeper, or inspector.

  2. Submitting incomplete information in the sections outlining the official capacity and event type the individual is certified for. Every field in these sections is crucial to clearly define the scope of the individual’s certification.

  3. Omitting the date when the training was completed. This date is essential as it confirms the individual’s certification is current and fulfills annual proof requirements.

  4. Failing to correctly list the instructor's name who conducted the training. This ensures accountability and allows for verification of the individual’s claimed training.

  5. Leaving the certifying organization's contact information blank. This form serves as a legal document, and contacting the certifying organization may be necessary for further verification.

  6. Forgetting to include the city and state with the address of the certifying organization, which is necessary for completeness and compliance with the Department's requirements.

  7. Neglecting to print or type the name of the authorized representative. This is a common mistake that can lead to misunderstandings about who has actually certified the individual.

  8. Omitting the signature of the authorized representative. A signature is a key part of the form’s validation process, legally binding the assessment and certification of the individual’s skills and experience.

  9. Not paying attention to the form’s submission guidelines, either by sending it to the wrong address or using an incorrect fax number. Accurate submission ensures your form reaches the intended destination without delays.

To avoid these mistakes, individuals and certifiers alike are advised to review the form carefully, ensure all required fields are thoroughly and accurately completed, and double-check the form’s instructions for submission. Taking these steps can smooth the path toward certification and greatly contribute to maintaining the standards and safety of combative sports in Washington State.

Documents used along the form

When navigating through the administrative process of becoming certified or maintaining certification for combative sports in Washington State, individuals typically need to engage with several forms and documents in addition to the Pa 611 028 form. These documents are crucial for proving experience, skill, training, and for meeting regulatory compliance. They encompass a range of certifications, personal details, and sometimes medical clearances, each serving a unique but complementary purpose in the broader context of licensure.

  • Application for Combative Sports License: This form is necessary for anyone seeking to become licensed in combative sports, including fighters, promoters, and officials. It collects personal information and details about the applicant's experience and qualifications in combative sports.
  • Medical Examination Form: This document is generally required for fighters, ensuring they are physically fit to compete. A licensed medical professional must complete it after conducting a thorough examination.
  • Event Permit Application: Promoters organizing combative sports events must submit this form. It outlines the event's details, including date, location, and the fighters participating.
  • Proof of Insurance: Participants and promoters often must provide documentation showing that they have adequate insurance coverage for injuries or damages that may occur during an event.
  • Concussion Acknowledgment and Information Form: Athletes and officials are required to acknowledge the risks of concussions and affirm they have received information on concussion symptoms and recovery. This furthers the commitment to athlete safety.
  • Professional Record Update: Fighters must submit this form to update their professional records, including wins, losses, and other pertinent career details. This information is essential for matchmaking and rankings.
  • Training Verification Form: Similar to the Pa 611 028 form, this document provides additional details about the training and experience of individuals applying for a license. It may include information about specific programs completed and certifications earned.

Together, these forms and documents form the foundation of a robust regulatory framework, ensuring that all parties involved in combative sports in Washington State are qualified, healthy, and informed about the risks and responsibilities involved. Each document plays a distinct role in safeguarding the integrity of the sport, protecting the health and well-being of its participants, and ensuring the safety of events for spectators and athletes alike.

Similar forms

The PA 611 028 form, which facilitates the certification of officials in combative sports, shares similarities with other regulatory documents designed to ensure qualified individuals oversee professional sporting events. These documents ensure that officials have the required training, experience, and skills to maintain fair play and safety during competitions.

One such document is the Professional Referee Organization (PRO) Certification. This certification aims to standardize the qualification process for referees in various sports at the professional level. Like the PA 611 028 form, the PRO Certification requires individuals to undergo rigorous training and demonstrate their competency in officiating at a high level. Both forms emphasize the need for annual proof of certification and adequate experience, underscoring the importance of maintaining current standards in officiating skills and knowledge.

Another document with notable similarities is the National Collegiate Athletic Association (NCAA) Official Certification. This certification is pivotal in ensuring that individuals officiating college sports meet specific educational and training benchmarks. Similar to the PA 611 028 form, the NCAA certification process involves assessing the official's experience, skill, and ability to enforce the rules fairly and consistently. Both certifications are crucial in promoting integrity and fairness in sports competitions, although their scopes cover different levels of competitive sports.

Lastly, the USA Boxing Official's Certification bears resemblance to the PA 611 028 form. It aims at regulating officials in amateur and professional boxing, focusing on the safety and fairness of the sport. Both documents necessitate an evaluation of the individual’s experience and skill, but the USA Boxing certification also includes specific training related to the boxing sports context. Despite the difference in focus, both processes affirm the overarching goal of ensuring that only the most qualified individuals officiate sporting events.

Dos and Don'ts

When completing the PA 611 028 form for Combative Sports Certification of Official, it's crucial to follow specific guidelines to ensure the process is done accurately and efficiently. Paying attention to both the do's and don'ts can streamline the application process and increase the chances of approval. Here are things you should and shouldn't do:

Do's:

  1. Provide thorough information: Ensure that all sections of the form are filled out with accurate and detailed information. When describing the individual's skills, experience, and abilities, include specific examples that demonstrate their competency in the official capacity for which they are being certified.
  2. Ensure legibility: Either type or print in clear handwriting to avoid any misinterpretations of your submission. Unclear information can lead to delays or outright rejection of the application.
  3. Verify certification credentials: Before submission, double-check that the certifying organization is approved by the Department. Including certification from an unapproved organization can invalidate your application.
  4. Keep a copy for your records: Prior to sending the form, make a copy for personal records. Having a copy can be helpful in the event of disputes or if the form gets lost in the mailing process.

Don'ts:

  1. Avoid leaving sections blank: Each section of the form should be completed in its entirety. If a section does not apply, indicate this with a “N/A” (not applicable) to show that the question was acknowledged but not applicable.
  2. Refrain from using unprofessional language: When describing the individual’s abilities or filling out any part of the form, maintain a professional tone and use appropriate terminology. Unprofessional language can undermine the individual’s candidacy.
  3. Do not guess on details: If unsure about specific dates, capacities, or experiences, it's better to verify the information before submission to avoid inaccuracies. Guessing can lead to incorrect information that might question the credibility of the application.
  4. Do not submit without signing: The form requires the signature of the authorized representative to be considered complete. Submitting the form without the necessary signature will render it invalid.

Misconceptions

Understanding the PA 611 028 form related to the certification of officials in combative sports in Washington State is crucial for those entering this field. However, there are several misconceptions which can lead to confusion. Let's clarify these points.

  • It's only for referees and judges: One common misconception is that this form is exclusively for referees and judges. In reality, the PA 611 028 form is used for certifying individuals in various official capacities, including timekeepers and inspectors, for professional or amateur combative sporting events.
  • Experience isn't verified: Another misunderstanding is that the experience, skill, and training of an individual are not thoroughly checked. This form actually requires a detailed assessment of the individual's abilities, including specific examples of their experience and skills. The certifying organization is responsible for attesting to the adequacy of the candidate's qualifications.
  • Any organization can certify: It's also incorrectly assumed that any organization can provide the necessary certification. The truth is, only organizations approved by the Department can certify officials. This ensures a standardized level of competency and safety in the sport.
  • Certification is a one-time process: Some might think that once they are certified, they do not need to renew their certification. Contrary to this belief, the form outlines the need for annual proof of certification. This continual process ensures that officials remain updated on best practices and maintain their skills.
  • It applies only to professional combative sports: The assumption that the certification is only needed for professionals is incorrect. The PA 611 028 form explicitly lists amateur mixed martial arts among the events for which officials must be certified. This highlights the comprehensive approach to regulating all levels of combative sports, ensuring the safety and integrity of both amateur and professional events.
  • The process is discriminatory: Finally, there might be concerns about discrimination in the certification process. However, the form itself and the process it represents are designed to be inclusive, adhering to commitments of providing equal access to services. Accommodations are explicitly offered to those who may need them, ensuring the process respects the diverse needs of all applicants.

In summary, the PA 611 028 form plays a vital role in the regulation and safety of combative sports in Washington State, underlining the importance of a thoroughly vetted and continuously updated certification for officials. Understanding these common misconceptions can help individuals effectively navigate their certification or recertification process.

Key takeaways

Fulfilling the requirement of the PA 611 028 form is an essential step for professionals looking to be licensed as officials in combative sports events in Washington State. Here are five key takeaways when filling out and using this form:

  • Annual Proof of Certification: Individuals must provide annual proof of certification to either be approved for the first time or to maintain their current license. This certification must verify that the applicant has sufficient experience, skill, and training in their chosen official capacity, ensuring they are capable of performing their duties at professional or amateur combative sporting events.
  • Approved Organizations: The certification proving the applicant's experience, skill, and training must come from an organization that the Department approves. It's critical to ensure that the organization providing your certification is recognized by the Department to avoid delays or rejections in the application process.
  • Detailed Assessment Required: The form requires a detailed assessment of the applicant's skills, experience, and abilities to perform in their desired official capacity. This assessment must include specific examples that illustrate the applicant's qualifications, providing a comprehensive overview of their capability to the Department.
  • Contact Information: Upon completion, the PA 611 028 form must be sent directly to the Combative Sports Program, Department of Licensing, either via mail or fax. Providing accurate contact information, such as the address, phone number, and signature of the authorized representative from the certifying organization, is essential for the form's processing.
  • Accessibility: The Department is dedicated to providing equal access to its services. If you require any accommodation while filling out or submitting this form, they encourage you to contact them directly through the phone numbers provided on the form, ensuring that all individuals have the opportunity to apply regardless of disability.

Completing the PA 611 028 form correctly and comprehensively is vital for those seeking licensure to officiate at combative sporting events in Washington State. Ensuring that all requirements are met and that the form is submitted to the correct departmental address will facilitate a smoother application process.

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