Title / Gender / Male / Other
Female / Prefer not to say
Address
Postcode / Date of birth
Phone / Mobile
Do you have a disability? / Yes / No / Prefer not to say
Do you coach athletes / players with a disability?
Physical - wheelchair / Physical - ambulant / Sensory - visual / Sensory - hearing / Learning
Current level of coaching:
Pre-leaders / Leaders / Level 1 / Level 2
Frequency of coaching:
3 times/week / 1-3 times/week / Weekly / Monthly / Less
How long have you been coaching?
< 2 years / 2-5 years / 5-10 years / 10-20 years / >20 years
Current coaching responsibilities:
Lead / Support / Assistant
Please detail:
Are you part of the PVG system? / Yes / No
Please provide name and location of club where you are currently coaching:
Please read the information overleaf and sign the form.
HOW INFORMATION ABOUT YOU WILL BE USED
Personal information which you supply to SDS may be used in a number of ways, for example:
- To administer and manage your details;
- To review, develop and improve the services and activities offered by us;
- To provide you with details of forthcoming activities, events, tournaments and competitions (as well as those of selected third parties including our partner organisations and branches);
- To research, develop and manage new and existing programmes and projects and to promote our sport;
- To monitor compliance with equal opportunities legislation and the Equality Standard For Sport and to promote and maintain equality of opportunity or treatment;
- For statistical analysis;
- To share with other Scottish Governing Bodies, sportscotland, SDS Branches and Local Authorities.
HOW TO CONTACT US
For further information on how your information is used, how we maintain the confidentiality of your information, and your rights to access information we hold on you, please write to us at: Administrator, Scottish Disability Sport, Caledonia House, South Gyle, Edinburgh, EH12 9DQ or e-mail .
By signing this form you agree that SDS may use and disclose your information for the purposes described above.
If you are not yet 16 this form should also be signed and dated by your parent or guardian.
Signed: / Date:Parent/guardian: / Date:
Name (print):