1st4sport Qualifications

The awarding body for active learning and leisure

Rowing Coach Education Course
Candidate Application Form 4.1Level 1 & 2 Indoor Rowing,Level 2 & 3 Certificates in Coaching Rowing, Tutor AssessorTraining.

Core Information-Please complete all sections in BLOCK CAPITALS.

* indicates mandatory information

Surname* / Title*
First name* / Known as name
Gender* / Female / Male / Date of Birth*
Full Home Postal Address*
Postcode*
Home Telephone No.* / Work Telephone No.
Mobile* / Fax
E-mail*
ROWHOW or British Rowing number** / Club

**Non British Rowing/WARA members are required to register with ROWHOW to access course resources prior to the course closing date. ROWHOW or (W) British Rowing membership number MUST be supplied. All candidates for water based courses must have Thirdparty insurance for water based activities (EG SARA membership)

Medical conditions/Additional Learning Needs

Do you have any medical conditions, impairments, disabilities or learning difficulties of which the Course Organiser, Tutors or Assessors should be aware?* / Yes / No*
If yes, give brief details:
If YES, do you require any additional support / special arrangements to take part and complete the course?
If YES, contact the Course Organiser before the course closing date. / Yes / No
Course Details
Qualification
applied for
Tick one only* / Level 1 Certificate in Coaching Indoor Rowing
Level 2 Certificate in Coaching Indoor Rowing
Level 2 Certificate in Coaching Rowing / √
Level 3 Certificate in Coaching Rowing
CTS
IAP’s
Course dates* / 19/08/2013 – 22/08/2013 / Course fee attached* / £
Course venue* / Crosby Lakeside / VAT Registered? * / Yes / No
Ethnicity Details *
I would describe my ethnic origin as:
White British / White Irish / White European
White Non-European / Mixed White and Black Caribbean / Mixed White and Black African
Mixed White and Asian / Other Mixed Background / Indian
Asian British Indian / Pakistani / Asian British Pakistani
Bangladeshi / Asian British Bangladeshi / Other Asian
Black Caribbean / Black African / Black British
Other Black / Chinese / Other
Prefer not to say
Coach Profile Information
Do you hold any rowing Coaching Awards?* / Yes / No
Do you hold any other relevant qualifications? i.e Level 2 Fitness Instructor etc – please state.
If Yes, please state your current level
e.g. Dry Instructors, Level 2, Bronze, etc.

CRB Clearance

British Rowing has a Safeguarding & Protecting Children Policy which requires all Coach Educators and Coaches working with young people and vulnerable adults to undertake a CRB check.
Are you/will you be working with young people?* / Yes / No
If yes, have you completed a CRB enhanced disclosure? / Yes / No
CRB Number
  • Ifno to the second question: More information is available at - or ring HQ on 020 8237 6700

ALL Applicants to sign:

I understand and agree that, if I fail to start or complete the course, part of the course fee will only be refunded in exceptional circumstances and at the discretion ofBritish Rowing.
Failure to attend the allotted assessment day/time will result in additional charge.
I understand that Rowing has adopted the sportscoachUK Code of Conduct. I agree to uphold its principles and practices in my coaching and agree to abide by the rules of British Rowing.
Signature: Date:

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© BR and Coachwise Ltd, 2006.

This information will be used to register you with the awarding body 1st4sport Qualifications and by the governing bodies of rowing to support the development of the sport. Version 8 –2nd October 2009