DOWNPATRICK SCHOOLOF LIFE SAVING
Assistant / Teacher Application (WEB) Form
Please complete all details and return this form to the Registrar,together with the club membership fee ______
DSL is on Facebook & Website:
Downpatrick School of Life Saving records are now held on computer
DOWNPATRICK SCHOOLOF LIFE SAVING
Assistant / Teacher Application (WEB) Form
Please complete all Sections in BLOCK CAPITALS
SURNAME...... '......
FIRST NAME......
ADDRESS......
…………………………………………………………………………….
POSTCODE......
DATEOF BIRTH......
HOME PHONE......
MOBILE......
EMAIL: ......
......
EMERGENCY CONTACT NAME......
PHONE......
MOBILE......
RLSS No. ………………………………. Expiry date ….………..
Awards held & Expiry date:( latest LS3)……………………......
………………………………………………………………………….
………………………………………………………………………….
………………………………………………………………………….
UNDERTAKING
I/we do hereby undertake as follows: To indemnify you, your officers, agents, servants from all liability and costs, and expenses, in respect of any claim from any person or persons, in respect of any damage, loss, accident, mishap or occurrence arising out of or in any way connected with the operation of the Downpatrick School of Lifesaving, notwithstanding that any such claims of demands may have arisen from the negligence law, nuisance or other sort, for which you, your officers, agents or servants would otherwise have been liable.
I have read copies of the Code of Conduct, Role Descriptor, the Junior Club Membership Rules and the teacher’s agreement.
I hereby give my consent to video/photos of myself / my child being taken and used for assessment criteria or publicity for the Club.
I am aware that I must hold individual membership of the RLSS UK and that I will be enrolled on the Volunteer Now Clubmark Scheme.
Signature …………………………………………………... Date ……………..
Signature of Parent ...... Date......
(If under 18)
Evidence of any awards held & RLSS UK membership will be required.
DSL is on Facebook & Website:
Downpatrick School of Life Saving records are now held on computer
DOWNPATRICK SCHOOLOF LIFE SAVING
Assistant / Teacher Application (WEB) Form
DSL is on Facebook & Website:
Downpatrick School of Life Saving records are now held on computer
DOWNPATRICK SCHOOLOF LIFE SAVING
Assistant / Teacher Application (WEB) Form
MEDICAL INFORMATION Do you suffer from any illness, medical condition or are you taking any medication of which we should be aware? (E.g. Asthma, diabetes, heart complaint, allergy to penicillin, elastoplast etc.)
Please supply the name and address of a person to be contacted for a reference ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
DSL is on Facebook & Website:
Downpatrick School of Life Saving records are now held on computer
DOWNPATRICK SCHOOLOF LIFE SAVING
Assistant / Teacher Application (WEB) Form
I have read the Teachers Agreement and I can comply with the requirements of the School of Lifesaving. I understand it is my responsibility to be in current my individual membership of the RLSS UK.
Signed ……………………………………………………. Date ……………….
Application for individual membership of the R.L.S.S can be obtained from
- Redhill House, 227 London Rd, Worcester WR5 2JG
- Telephone 0300 323 0096(Quickest way is pay by card and ask for membership number which you give to Yvonne or Lisa.)
- Or online at:
DSL is on Facebook & Website:
Downpatrick School of Life Saving records are now held on computer