Volunteers Form





GUILDFORD CITY STAFF FORM FOR VOLUNTEERS
(This form must be completed by a volunteer 18 years+ or by a Parent/Guardian).


1. IF YOU ARE COMPLETING THIS FORM AS A PARENT OR GUARDIAN ON BEHALF OF AN APPLICANT PLEASE GIVE YOUR DETAILS BELOW (if you are the applicant please start from section 2):

Parent / Guardian Details

Full Name

Relationship to Volunteer

Address (if different from volunteer’s address)

Email Address

Mobile Number for use in Emergency


2. . PLEASE STATE VOLUNTEER POSITION APPLIED FOR

e.g. Aquatic Helper (Poolside Helper); DoE Volunteer; Volunteer for GCSC/A level PE Exam; Volunteer Teacher; Volunteer Coach; other please state:


3. PLEASE GIVE THE NAME OF THE PERSON WITH WHOM YOU HAVE BEEN IN CONTACT REGARDING VOLUNTEERING IN THE CLUB

e.g. Claire Nash / Jan Griffiths / Richard Garfield if other please state name & Squad


4. VOLUNTEER APPLICANT’S DETAILS

First Name

Middle Name

Last Name

Date of Birth

Address

Post Code

Your Email (required)

Please note that the Club uses email to communicate with its staff and an up to date email address is essential. The Club will not communicate through parent’s email addresses or mobile phones or any other third party.

Home Phone No

Mobile

Please give your Squad Name if you are a Club Swimmer:

Squad Name:

If you are a Club Member please let us know if you are related to a swimmer(s) in the Club and their Squad(s). If any other reason for Club Membership please also state below:

Swimmer Name(s):

Squad(s):

Other reason:


5. APPLICANT’S QUALIFICATIONS IF RELEVANT

Please complete the following:

ASA Qualified Coach  Yes No
If ‘Yes’ please state the level

ASA Qualified Teacher  Yes No
If ‘Yes’ please state the level

STA Qualified Teacher  Yes No
If ‘Yes’ please state the level

and expiry date

ASA Aquatic Helper’s Certificate  Yes No


6. SAFEGUARDING AND PROTECTING CHILDREN COURSE (COMPULSORY) DO NOT GIVE INFORMATION ON EXPIRED CERTIFICATES (CERTIFICATES VALID FOR 3 YEARS FROM DATE OF ISSUE)

It is compulsory for all employees who are 18 years or over, who may have contact with swimmers, to have a Safeguarding & Protecting Children Certificate and to have attended an ASA approved course. If you do not have an approved Certificate you will be sent information on courses – full bursaries available.

I currently hold an ASA Approved Safeguarding Certificate.  Yes No

If ‘Yes’ please state which Organisation the Safeguarding Certificate was issued through (eg Sports Coach Uk):

Date of Issue


7. LIFE SAVING CERTIFICATES (THESE ARE NOT COMPULSORY FOR MOST POSITIONS UNLESS OTHERWISE DISCUSSED) PLEASE DO NOT GIVE INFORMATION ON EXPIRED CERTIFICATES

NPLQ Certificate  Yes No
If ‘Yes’ please state the expiry date

Water Safety Certificate  Yes No
If ‘Yes’ please state who this was issued through

and the expiry date

Although not compulsory should applicants wish to keep NPLQ/Water Safety Certificate’s current, applicants should undertake 2 hours of update training every month:
Please State where update training takes place if applicable:

On the following days and times


8. DBS CERTIFICATE PLEASE DO NOT GIVE EXPIRED DBS INFORMATION (DBS CERTIFICATES EXPIRE 3 YEARS FROM DATE OF ISSUE)

It is compulsory for all applicants 16 years and over, who may have contact with swimmers, to have an enhanced DBS Certificate (no cost involved). Checks must have been undertaken by an ASA Club and be less than 2.5 years old (certificates are valid for 3 years but must be rechecked from 2.5 years for new staff). If you have subscribed to the DBS update Service the ASA will check your current certificate once you have completed a consent form (see below).

DBS Certificate  Yes No
If ‘Yes’ please state:-
DBS Certificate No.
ASA Club DBS Issued through

The expiry date

Have you registered with the DBS Update Service? Yes or No:
If Yes a consent form allowing the ASA to check your certificate will be emailed to you.


9. IOS INSURANCE – PLEASE DO NOT GIVE EXPIRED INSURANCE DETAILS

If you have separate IOS Insurance please state the number and expiry date:

My IOS Insurance No. is

Expiry Date is


10. REFEREES

If you (applicant) are a current Club Member, you must still provide 2 referees as explained below, however 1 of the referees may be a coach within the Club.

Referees should be a current employer, tutor, teacher etc and must not be related to you (applicant).

a) Referee Name

Relationship To Applicant

Email Address

Postal Address

b) Referee Name

Relationship To Applicant

Email Address

Postal Address


11. MEDICAL DETAILS OF VOLUNTEER

To be completed by applicants 18 years or over, or by parent / guardian of applicants under 18 years old.

Please select Yes or No as appropriate and complete further details as appropriate.

Do you (or if completed on behalf of an applicant) have any specific medical conditions requiring medical treatment and / or medication that are likely to affect your work?
Yes No 
If yes, please give details of condition and medication etc:

Any other relevant information?


12. MEDICAL INTERVENTION FOR UNDER 18S

The following must be completed by a parent / guardian for applicants under 18 & in doing so this means you agree to the following medical intervention if necessary

It may be essential at some time for the Club to have the necessary authority to obtain any urgent treatment which may be required whilst working for Guildford City Swimming Club at any of the pools they operate from.

I, being the parent / carer of the above named volunteer hereby give permission for the club to give the necessary authority on my behalf for any medical or surgical treatment recommended by competent medical authorities, where it would be contrary to my son / daughter’s interest, on the doctors medical opinion, for any delay to be incurred by seeking my personal consent.

Signature of Consent by Parent / Carer


13. DATA PROTECTION

I understand that, in compliance with the Data Protection Act 1998, all efforts will be made to ensure that this information is accurate, kept up to date and secure and that it is used only in connection with the purpose and activities of the club. Information will not be kept once a person is no longer member of staff. The information will be disclosed only to those members of the club for whom it is appropriate and relevant officers of the Amateur Swimming Association or British Swimming.


14. SIGNATURE

Please read the statement below and print your name in a) or b) as appropriate. By printing your name you are accepting any terms and conditions.

a) I am the volunteer named in Section 2 and I have completed this form accurately and accept any terms and conditions:

Print Volunteer Name:

b) I am the Parent or Guardian of the volunteer stated in Section 1 and I have competed the form accurately and accept any terms and conditions.

I understand and accept that once the applicant name above has been employed by the Club, all communication from and to the Club will be with the applicant only.

Print Parent/Guardian Name:

Date

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This form will be sent direct to Janette Smith Human Resources Manager and a “Thank You” email will be sent on receipt. We will then be in touch with further information.