Instructors Database Instructor Details Form

Transcription

1 This form is for you to provide the necessary information to comply with The Pony Club rules and other legal requirements. While the Branch(es)/Centre(s) you coach for may have some information about you stored on the Instructors Database, there will be some areas that are missing, so the intention of this form is for you to provide that missing information. The fields found on this form are the same as the fields required on the Instructors Database. Only those people listed on the database, who fulfil the necessary requirements (as listed on are permitted to coach or instruct at Pony Club activities. The Pony Club office provided a free data upload service until 30th April 2015 for coaches/instructors not yet listed on the database. From 1st May 2015, a charge of 5 per entry is required to add further instructors to the databases. Branch officials are still able to add instructors to the database themselves without incurring a cost. Before you start, you will need to provide the following information, where relevant: 1. Details of the latest Instructor Course (CPD) you have attended 2. Details of your disclosure check (DBS, CRB, PVG or Access NI) and a copy of your certificate (this can be uploaded electronically as you go) 3. Details of the first aid course you have attended and a copy of your certificate (this can be uploaded electronically as you go) 4. Details of the safeguarding course you have attended and a copy of your certificate (this can be uploaded electronically as you go) You may not be required to provide all of this information, depending on what level of coach you are. If you don't have all of the information you are asked for, please just fill in what you can, but be aware that you do not fulfil the requirements, you will not be eligible to coach until you are fully up to date. PLEASE ENCLOSE PAYMENT OF 5.00 Cheques should be made payable to The Pony Club or card details supplied below: Cardholder name: Credit / Debit Card Number: Start Date: Expiry Date: Issue : Security : 1

2 Please complete all sections required, as explained in the notes below. This form is used for you to provide the necessary information to comply with The Pony Club rules and other legal requirements. While the Branch(es)/Centre(s) you coach for may have some information about you stored on the Instructors Database, there will be some areas that are missing, so the intention of this document is for you to provide that missing information. The fields on this form are the same as the fields required on the Instructors Database. The Pony Club Office will upload the data gathered using this form for all instructors/coaches received by Friday 27 th February 2015 onto the Instructors Database, in order to achieve a complete list of Instructors used for Pony Club activities. Once all of the data supplied has been added to the Instructors Database, only those people listed, who fulfil the necessary requirements will be permitted to coach or instruct at Pony Club activities. Section 1 Personal Details TO BE COMPLETED BY ALL Section 2 Instructor Record TO BE COMPLETED BY ALL Completion of Sections 3 8 depend on the Instructor/Coach Category you should be in. Please follow the instructions in Section 2. Section 3 Continuing Professional Development Section 4 Criminal Conviction Disclosure Section 5 Safeguarding and Protecting Children Workshop Section 6 First Aid Section 7 - Instructor s Folder (Fully Accredited coaches) Section 8 - Instructor s Folder (Supervised / Volunteer coaches) Section 9 - TO BE COMPLETED BY ALL SECTION 1. Personal Details FULL NAME ADDRESS LINE 1 ADDRESS LINE 2 TOWN COUNTY POSTCODE * PHONE MOBILE *All instructors/coaches must supply an address. SECTION 2. Instructor Record PRIMARY PONY CLUB AREA PRIMARY BRANCH / CENTRE This is the Branch/Centre/Area you coach for most IS THIS THE ONLY BRANCH/CENTRE YOU WANT TO COACH FOR?

3 PLEASE LIST ANY OTHER BRANCHES / CENTRES YOU COACH FOR WHAT DATE / YEAR DID YOU BEGIN COACHING FOR THE PONY CLUB? Please estimate if unknown WHAT IS THE HIGHEST LEVEL YOU COACH FOR? PREFERRED DISCIPLINE Please select ONE only WHAT IS THE HIGHEST LEVEL OF PONY CLUB TESTS YOU ASSESS FOR? All levels E / D Test D+ / C Test C+ Test B Test B+ / AH / A Test General / All Dressage Endurance Eventing Games Polocrosse Polo Pony Racing SJ Tetrathlon I m not an assessor E D D+ C C+ B B+ AH A PLEASE LIST YOUR COACHING QUALIFICATIONS (if applicable) ARE YOU A BHS REGISTERED INSTRUCTOR? ARE YOU A REGISTERED COACH FOR ANY OTHER EQUESTRIAN ORGANISATIONS? ARE YOU A PONY CLUB VISITING COACH? DO YOU WISH FOR YOUR RECORD TO BE GIVEN FULL PRIVACY? British Dressage British Eventing British Showjumping Endurance GB ABRS RDA UK Polocrosse Other: [VCs are approved by the Training Committee and listed on If you request Full Privacy then you will not be visible in any searches performed by other Branches, Centres or Areas. You will still be viewable to your primary Branch/Centre, the Area Rep, and The Pony Club office. If you have requested Full Privacy, you must provide a reason why. Please state why if YES: You now need to identify which Instructor/Coach Category you are. Please select one. 1. Fully Accredited Equestrian Coaches / Instructors These Coaches / Instructors can take sole charge of The Pony Club groups they coach, without supervision. Please complete Sections 3, 4, 5, 6 and Supervised Coaches / Instructors These Coaches / Instructors must not earn their main income from coaching riding. They may be paid to coach for The Pony Club. They must be supervised (within full sight and sound at all times) by a Fully Accredited Coach (category 1), the DC or Centre Proprietor, or any other official who fulfils the requirements for category 1. Please complete Sections 3 and 8. If you coach regularly (i.e. four or more times within any 30 day period) also complete Sections 4 and Volunteer Coaches / Instructors These Coaches / Instructors must be unpaid and supervised by a Fully Accredited Coach (category 1), the DC or Centre Proprietor, or any other official who fulfils the requirements for category 1. 3

4 Please complete Section 8. If you coach regularly (i.e. four or more times within any 30 day period) also complete Sections 4 and Coaches / Instructors for non-riding / horse related activities These Coaches / Instructors can be used for coaching sports / disciplines other than riding for Pony Club activities e.g. Swimming, Shooting, Running. Please complete Sections 4, 5 and 6. SECTION 3 - Continuing Professional Development (CPD) Pony Club Instructors/Coaches must attend a Pony Club CPD course at least once every two years. The only exceptions are: BHS Registered Instructors may use their BHS CPD Registered Coaches for other Equestrian Organisations may use their CPD from that organisation but may only coach that discipline within The Pony Club, if they are a coach for a specific discipline organisation. If they wish to coach other disciplines for The Pony Club, they must attend a Pony Club CPD course. e.g. BD registered coaches need not attend Pony Club CPD, but may only coach Dressage within The Pony Club. If they wish to coach any other discipline, they must attend a Pony Club CPD course. OF THE LATEST PONY CLUB CPD COURSE YOU ATTENDED WHERE WAS THE COURSE HELD? WHAT WAS THE TITLE OF THE COURSE? If you are a BHS Registered Instructor and haven't attended Pony Club CPD, please supply the date of your latest BHS CPD. If you are a Registered Coach for another organisation and haven't attended Pony Club CPD, please supply the date of your latest relevant CPD for that organisation. SECTION 4 Disclosure Check Fully Accredited and Pony Club Instructors/Coaches who coach regularly must have an up to date enhanced disclosure check. This should have been completed in the last three years. If the certificate contains any information it must be reported to The Pony Club for consideration following The Pony Club s procedure, in order that the insurers can be informed and for the insurance to remain valid. PLEASE SELECT THE DISCLOSURE TYPE: CRB DBS* PVG Access NI PLEASE SUPPLY THE CERTIFICATE DATE OF ISSUE *ARE YOU SUBSCRIBED TO THE DBS ONLINE UPDATE SERVICE? DISCLOSURE CERTIFICATE WITH THIS FORM Subscription to the online update service requires an annual fee ( 13 per year or free for volunteers) This will be destroyed once it has been checked, in line with data protection legislation SECTION 5 - Safeguarding and Protecting Children Workshop These should be attended at least once every three years. In the first instance, Instructors/Coaches must attend a course in person. If you are unable to attend a Pony Club Safeguarding and Protecting Children Workshop, Sports Coach UK and British Horse Society (BHS) courses are also accepted. OF THE WORKSHOP YOU ATTENDED 4

5 CERTIFICATE WITH THIS FORM SECTION 6 - First Aid Course These need updating every two or three years, depending on which course you do. The following courses are accepted: First Aid at Work (expires after three years) Equine Specific First Aid Course (expires after two years) Emergency First Aid at Work, or any other one-day First Aid course including resuscitation (usually expires after three years check the date on your certificate) PLEASE SELECT THE FIRST AID COURSE TYPE: FAW ESFAC EFAW / 1 day course OF THE COURSE CERTIFICATE WITH THIS FORM SECTION 7 Instructor s Folder (Fully Accredited coaches) The Pony Club Instructor s Folder contains up to date information on Pony Club Tests, Health & Safety policies and other relevant information. Fully Accredited coaches should own a copy. DOYOU OWN A COPY OF THE PONY CLUB INSTRUCTOR S FOLDER? SECTION 8 Instructor s Folder (Supervised / Volunteer coaches) The Pony Club Instructor s Folder contains up to date information on Pony Club Tests, Health & Safety policies and other relevant information. Supervised / Volunteer coaches should have access to a copy, either at home or in the Branch/Centre. DOYOU HAVE ACCESS TO A COPY OF THE PONY CLUB INSTRUCTOR S FOLDER? SECTION 9 Thank you for providing your information. This will be added to the Instructors Database in the coming weeks. The Instructors Database is undergoing some improvements which will allow you to log in and maintain your own record, so that you can ensure you are up to date and eligible to coach for The Pony Club. You will receive timely reminders by when your CPD, DBS, First Aid and Safeguarding dates are nearing expiration (if required). You will also be contacted annually to ensure that your contact details and other personal information is up to date. The facility for you to log in to the Instructors Database will be available from 1 st October Your log in details will be sent by at this time. This means that there will be a short time between the data being added to the database and the Instructors/Coaches being able to log in and update their own record. During this interim period, we would very much appreciate it if you could inform your Branch/Centre of any changes or updates, so that your records are kept up to date. Please sign below to confirm that all of the information supplied is, to the best of your knowledge, correct, and that you have supplied the required certificate copies: Instructor/Coach signature: Date: 5