Parent / Guardian Details
Full Name
Relationship to Applicant
Address (if different from applicant’s address)
Email Address
Mobile Number for use in Emergency
e.g. Aquatic Helper (Poolside Helper) / Swimming Teacher / Swimming Coach; other please state
e.g. Claire Nash / Jan Griffiths / Richard Garfield / Janette Smith if other please state name & Squad
Surrey Sports Park YesNo
Spectrum Leisure Centre YesNo
We work at various pools in Guildford, Godalming, Aldershot, Bramley, Cobham
YesNo
Do you have a current Passport? Please type yes or no?
if yes please give the following information:
Passport Number
Passport Expiry Date
Country Of Issue
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
Under the Acts governing children in work, a Young Person’s Work Permit must be secured for all young workers (13-16) who are of compulsory school age and are being paid for work. *This is until the last Friday in June in the school year in which they reach the age of sixteen years. The hours that a young worker can work are restricted,
Permitted hours of work Employment may only take place between 7am and 7pm.
Hours of work for children aged 13 and 14 years • 2 hours on Sundays • 2 hours on school days (either one hour before and one hour after school, or two hours after school) • 5 hours on Saturdays • Maximum 12 hours per week during term time • 5 hours daily during school holidays but not to exceed 25 hours per week
Hours of work for children aged 15 years until they are no longer of compulsory school age • 2 hours on Sundays • 2 hours on school days (either one hour before and one hour after school, or two hours after school) • 8 hours on Saturdays • Maximum 12 hours per week during term time • Eight hours daily during school holidays but not to exceed 35 hours per week
Does the applicant need a Young Worker’s Licence? Yes or No
County in which the Applicant goes to School:
Details will be sent to the Parent / Guardian once work times & days have been agreed with the Line Manager.
Please complete the following:
ASA Qualified Coach YesNo If ‘Yes’ please state the level
ASA Qualified Teacher YesNo If ‘Yes’ please state the level
STA Qualified Teacher YesNo If ‘Yes’ please state the level
and expiry date
ASA Aquatic Helper’s Certificate YesNo
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. YesNo
If ‘Yes’ please state which Organisation the Safeguarding Certificate was issued through (eg Sports Coach Uk):
Date of Issue
NPLQ Certificate YesNo If ‘Yes’ please state the expiry date
Water Safety Certificate YesNo 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
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 YesNo 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.
If you have separate IOS Insurance please state the number and expiry date:
My IOS Insurance No. is
Expiry Date is
Please provide two professional referees. Referees must not be related to you, or be a friend (or family friend) or an acquaintance. Referees should be a tutor, teacher, or current employer. If in doubt please contact Janette Smith, Human Resources Manager (jsmith.hr@gcsc.co.uk)
a) Referee Name
Relationship To Applicant
Postal Address
b) Referee Name
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? YesNo If yes, please give details of condition and medication etc:
Any other relevant information?
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 applicant 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
In compliance with the General Data Protection Regulation 25 May 2018, we will ensure that all information held by the club is accurate, kept up to date and secure and that it is used only in connection with the purpose and activities of the Club. We will hold the data for 3 years after your last contact or from when you leave the club and then any information will be destroyed. The information will be disclosed only to those members of the Club / Swim England for whom it is appropriate and necessary. Swimming England has registered with Data Protection on behalf of member Clubs, counties and regions, enabling them to hold personal data of members etc. Records are kept on computer / Icloud platforms. Keeping information in this way enables us to run the club more efficiently. By pressing the ‘submit application’ button you are consenting to Guildford City SC holding your personal data for the purposes of this application as set out above and to give us permission to contact you. You can request information is deleted before the 3 years by contacting be gcsc.staff@gmail.com
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 applicant named in Section 2 and I have completed this form accurately and accept any terms and conditions:
Print Name:
b) I am the Parent or Guardian of the applicant 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
Please prove you are human
TThis form will be sent to Janette Smith Human Resources Manager, if you wish to receive an acknowledgement please contact Janette Smith, Human Resources Manager: Jsmith.hr@gcsc.co.uk.
