Parent / Guardian Details
Relationship to Volunteer
Address (if different from volunteer’s address)
Mobile Number for use in Emergency
e.g. Aquatic Helper (Poolside Helper); DoE Volunteer; Volunteer for GCSC/A level PE Exam; Volunteer Teacher; Volunteer Coach; other please state:
e.g. Claire Nash / Jan Griffiths / Richard Garfield if other please state name & Squad
Date of Birth
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
Please give your Squad Name if you are a Club Swimmer:
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:
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
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
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?
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 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
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 firstname.lastname@example.org
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:
Please prove you are human
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.