Role
    Please select one of the roles below:
    ParticipantInstructorVolunteer First name Surname Email address

    Home address: Postcode: Mobile number: Date of Birth (must be age 16 or over by the start of Sail Training): Please complete the self declaration form as part of our safeguarding policy
    Name: Gender: MaleFemale Do you have any convictions, cautions, reprimands or final warnings that are not protected as defined by the Rehabilitation of offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013)? YesNo
    If Yes please give details:

    Have you ever been known to any Children’s Services department or Police as being a risk or potential risk to children? YesNo

    If Yes please give details:

    Have you been the subject of any disciplinary investigation and/or sanction by any organisation due to concerns about your behaviour towards children? YesNo

    If Yes please give details:

    Confirmation of Declaration (tick box below) I declare that to the best of my knowledge the information given above is correct and understand that any misleading statements or deliberate omission may be sufficient grounds for disciplinary action and/or the withdrawal of my appointment.
    I understand that I may be asked to provide a Criminal Records Disclosure and consent to do so if required. I agree to inform the organisation within 24 hours if I am subsequently investigated by any agency or organisation in relation to concerns about my behaviour towards children or young people.
    I understand that the information contained in this form and in the Disclosure, or relating to subsequent concerns about my behaviour, may be shared with regulatory bodies and/or other persons or organisations, in circumstances where this is considered necessary to safeguard children.
    Electronic Signature
    Print name:
    Counter signature of parent / guardian if Volunteer is under 18: Print name: Date:

    If Participant, what course are you doing?

    Stage 2Stage 3Start Racing Photography Consent for both Sail Training and Brancaster Sailing Week It may be possible to organise a photographer to take photographs of the children taking part in Sail Training which will then be available for you to download from a private secure website using a supplied password. Please indicate whether you are happy or not for your children to be photographed. These images will not be used commercially or be supplied to any third parties, they are for your use only.
    Yes I am happy (for my child) to be photographedNo I am not happy (for my child) to be photographed

    Home address: Postcode: Mobile number: Date of Birth: For Dinghy and Senior Dinghy Instructors, please provide your RYA reference number, found on your Instructor certificate:
    Which qualifications do you hold?
    Assistant Instructor, expires: Dinghy Instructor, expires: Racing Endorcement, date of issue: Senior Instructor, expires: First Aid, expires: Power Boat Level 2, date of issue: Safety Boat, date of issue: Other:

    Please complete the self declaration form as part of our safeguarding policy
    Name: Gender: MaleFemale Do you have any convictions, cautions, reprimands or final warnings that are not protected as defined by the Rehabilitation of offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013)? YesNo

    If Yes please give details:

    Have you ever been known to any Children’s Services department or Police as being a risk or potential risk to children? YesNo

    If Yes please give details:

    Have you been the subject of any disciplinary investigation and/or sanction by any organisation due to concerns about your behaviour towards children? YesNo

    If Yes please give details:

    Confirmation of Declaration (tick box below) I declare that to the best of my knowledge the information given above is correct and understand that any misleading statements or deliberate omission may be sufficient grounds for disciplinary action and/or the withdrawal of my appointment.
    I understand that I may be asked to provide a Criminal Records Disclosure and consent to do so if required. I agree to inform the organisation within 24 hours if I am subsequently investigated by any agency or organisation in relation to concerns about my behaviour towards children or young people.
    I understand that the information contained in this form and in the Disclosure, or relating to subsequent concerns about my behaviour, may be shared with regulatory bodies and/or other persons or organisations, in circumstances where this is considered necessary to safeguard children.
    Electronic Signature
    Print name:
    Counter signature of parent / guardian if Instructor / Assistant Instructor is under 18: Print name: Date:

    Relevant Medical Conditions Do you have any relevant medical conditions to the activity of coastal dinghy sailing that the instructors and volunteers ought to be made aware of? YesNo

    Please give details including treatment
     

    Emergency Contact Details Please provide the details of one contact who will be within a 20 minute drive of the Sailing Club at all times.
    Name of Contact Parent/Carer/Relative or Friend Emergency Contact Number GDPR We seek your consent to hold all the information in this form for the duration of Sail Training this year. YesNo


    Please take care to observe the following: if anyone in your family has a fever or high temperature, a new continuous cough, or a loss of or change to their sense of smell or taste, you must not bring your child to sail training, and must self isolate at home in line with current guidance.

    For those travelling abroad before sail training please follow Government guidance on self-isolation on return to England unless the country is covered by the travel corridor exemption. Countries and territories can be taken off or added to this list at any time so please stay up to date with current travel corridors


     

    If you would like to complete another application, please click here after clicking submit