Coaches Register

COACHES REGISTER

MEMBERSHIP 2013-14

Benefits

Civil Liability Insurance

Personal Accident Insurance

Badminton Wales Membership

UKCC Coach Education Programme

National Coaches Conference

Coach Development Programme

Badminton Wales, Sport Wales National Centre, Sophia Gardens, Cardiff, CF11 9SW.

The Coaches Register

Members of the Coaches Register are licensed by Badminton Wales to carry out coaching duties within the parameters of the award that they have gained and will also have access to all the benefits listed on the front page.Acceptance onto the Coaches Register is subject to the satisfactory completion of a DBS check.

How to Join

1.Complete all sections of the form including the self-declaration form on page 4 where appropriate.

2.Return the form, either by sending a paper copy to the Badminton Wales office (Badminton Wales, Sport Wales National Centre, Sophia Gardens, Cardiff, CF11 9SW) marked for the attention of Rob Short or by sending an electronic copy to .

Payment methods

There are two payment options available to you, either by a chequemade payable to ‘WBU Ltd’ and sent to the Badminton Wales office at the above address or alternatively online via bank transfer. Badminton Wales’ account details are as follows:

Bank:Lloyds, Queen Street CardiffAccount Number:02529177Sort code: 30-96-91

NB. Please include your name and ‘Coaches Register’ in the reference.

What will happen?

When a DBS check has been successfully completed, you will be added to the register and your benefits will commence. Badminton Wales no longer produces Coaches Register membership cards. Instead, upon affiliation, you will be sent a letter and insurance certificate confirming your membership for the 2013-2014 season.

Membership of the register has a duration of up to 12 months with the renewal date being 30th September each year.

DBS and Self Declaration

Acceptance onto the Coaches Register is subject to the satisfactory completion of a DBS check requested by Badminton Wales.

Please read carefully and tick the applicable option:

• I do not have a current DBS check:Badminton Wales will apply for a DBS check on your behalf.
• I already have a current DBS check through Badminton Wales but have not signed up to the online DBS update system (N.B. the online update option was only available from June 2013): Please complete the self-declaration form attached on page 4.
• I already have a current DBS check through Badminton Wales or another organisation and have signed up to the online DBS update system: Please provide the relevant information below as recorded on your DBS certificate in order for us to carry out our checks.

Surname / D.O.B / Certificate Number

• None of the above applies: Badminton Wales will apply for a DBS check on your behalf.

If you fail to disclose an offence

If you fail to disclose an offenceon the DBS application form or on the Self-Declaration form then your registration will be suspended pending further investigation of the matter.

Membership Application

Membership Category (please tick as appropriate). If applying for a Family Membership, please complete a separate form for each family member.

Individual Membership / Family Membership / Number of Family Members

Fees

Full Membership£20.00
Family Membership£35.00for two people in same family,£50 for 3, £60 for 4
Personal Details
You have the right of access to information held on you and other rights under the Data Protection Act 1984.

Title: / First Name / Surname
Home address:
Post Code: / Date of Birth:
Email Address:
Badminton club/squad at which you will be carrying out your role: / Experience of coaching disabled people:
Other sports/clubs you have been involved in: / Contact number/s (in case of queries): / Home:
Mobile:
Work:

Will you be working with: Children Vulnerable Adults Both

Ethnic Origin

Asian British Bangladeshi / Black Caribbean / Other / Prefer not to say
Asian British Indian / Chinese / Other Asian / White British
Asian British Pakistani / Indian / Other Black / White European
Bangladeshi / Mixed White and Asian / Other Mixed Background / White Irish
Black African / Mixed White and Black African / Other White / White non-European
Black British / Mixed White and Black Caribbean / Pakistani

Coaching Profile
Please list all coaching levels attained if not previously provided or changes have occurred since your last registration

Coaching Level / Date Gained / Qualification (only required for ‘Other’)
UKCC Level 3
UKCC Level 2
UKCC Level 1
Advanced Award + UKCC L1 Orientation
Intermediate Award + UKCC L1 Orientation
Leader Award + UKCC L1 Orientation
Other

Disclosure & Barring Services Checks and BW sign-ups

I hereby consent to Badminton Wales, if required, undertaking police and/or social services checks against me. I understand that the information contained on this form, the results of police and social services checks and information supplied by third parties may be notified to my club/organisation and may be supplied by Badminton Wales to other persons or organisations that have an interest in child protection and vulnerable adult issues.

I confirm that I have read, understood and agree to abide by the Badminton Wales (tick as appropriate):

Code of Ethics and Behaviours

Safeguarding and Protecting Children Policy

(Both documents are available on the Badminton Wales website)

I undertake to inform Badminton Wales’ Lead Safeguarding Officer within 7 days if I receive any new relevant caution, reprimand, warning or conviction during the period whilst I continue to carry out the role to which my DBS check applies.

Signed by the above named individual:______Date:______

Badminton Wales Web Site

Badminton Wales will advertise the details of any coach on the Coaches Register (and thus licensed and insured by Badminton Wales) who has agreed to their details being publicised.

I wish / do not wish* to have my details publicised on the Badminton Wales Coaches Register web page.

* Delete as appropriate

I wish the following details to be submitted:

Name______

Contact Details:

Telephone*______Mobile*______E-mail*______

Other * (This could include your availability to coach, area covered etc)______

______

*Please include the details you wish to show on the web page.

Third Parties

Information is often requested by individuals, clubs, schools, and local authorities etc., as to coaches who are available in their area. Would you like your contact information passed on to such individuals/groups? (Please tick as appropriate)
YES NO

Self-Declaration

Because of the nature of the duties you are expected to perform in your role, you are required to complete a self-declaration form to disclose details of any unspent criminal convictions, cautions, reprimands or warnings since carrying out your last DBS check. Only relevant spent convictions and other information will be taken into account so disclosure need not necessarily prevent you from working in this role. Badminton Wales will treat any information you give here in confidence. It will be stored and disposed of securely and it will not be used unfairly against you.

The amendments to the Exceptions Order 1975 (2013) provide that certain spent convictions and cautions are 'protected' and are not subject to disclosure to employers, and cannot be taken into account. Guidance and criteria on the filtering of these cautions and convictions can be found at the Disclosure and Barring Service website.

Your role is exempted from the Rehabilitation of Offenders Act 1974, which means that all unspent convictions, cautions, reprimands and warnings on your criminal record need to be disclosed.

Is the role you will be working in a Regulated Activity? (A definition can be found
If yes, you must request a check against the Barred List. / Yes / No
Have you any unspent convictions or cautions, reprimands or warnings?
If yes, please give details of offences, penalties and dates below.
______
______
/ Yes / No
Are you a person known to any Children’s or Adults’ Services Department as being an actual or potential risk to children/Adults at Risk/other people?
If yes, please give full details below.
______
______/ Yes / No
Have you ever been investigated, had a sanction imposed against you or been disciplined in any way for any matter by a sports or other organisation’s governing body relating to child abuse, abuse of an Adult at Risk, sexual offences, violence or use of drugs or alcohol?
If yes, please give full details below.
______
______/ Yes / No
Is there any other information that you consider relevant to this application (and which Badminton Wales is entitled to know) that you would like to bring to our attention?
If yes, please give full details below.
______
______/ Yes / No

Print Name: ______Signed:______Date:______

Badminton Wales, Sport Wales National Centre, Sophia Gardens, Cardiff, CF11 9SW.