COACH REGISTRATION
FORM FOR GRAPPLINGUK COACHES/INSTRUCTORS REGISTRATION
March 28th 2010
GUK Coach Fee £95 This is cover for Coaching GUK Members Only
GUK Commercial Coach Fee £130 This allows you to Coach non Members
expires March 27th 2011
All questions to be completed fully in block capitals. All Coaches/Instructors must be registered with the Criminal Records Bureau, have a recognised First Aid Certificate and hold a valid Coaching Qualification or Instructors Certificate of Competence
Limit of Indemnity £2 million
Please Note : Insurance will not commence until a correctly completed and signed proposal form and your cheque is received by our insurance broker Worldwide Sports Insurance Uk Ltd . All cover is subject to the terms, conditions and exceptions of the master policy held by our broker and is available for inspection upon request. Please read the following declaration, sign at the bottom and return this form, together with your cheque.
Declaration: I declare that to the best of my knowledge and belief there are no known incidents or circumstances that might give rise to a claim.
Signed ... ... ... ... ... ... ... ... ... ... ... ... ... ... .. Date ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .
You can pay over the internet via Internet Banking or Paypal or Cheque
Please send form via Email when possible IBFBCSA@googlemail.com
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Surname |
Christian (First) Name |
Address |
Town |
CountyPO Code |
Date of Birth |
Club |
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Qualification or Certificate |
First Aid Certificate |
Years of Coaching |
Martial Arts Grade if any |
e.mail |
Tel No |
other relevant information |
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