Title *

Forename *

Surname *

Date of Birth *

Address *

Postcode *

Preferred Contact Telephone Number (this should be a parent's number if under 16) *

Email address (this should be a parent's email if under 16) *

Emergency Contact Name *

Emergency Contact Telephone Number (must be different to phone number above) *

Position Applied for

Please could you give the reason(s) that you would like to volunteer (or are currently volunteering) with Colchester Phoenix? *

Please give details of any previous experience of being in an environment with a child with additional needs. *

Please give a description of your swimming ability, including attendance of swimming club/lessons and level reached. *

Do you hold any current swimming teacher; swim coaching, rescue test, lifesaving or first aid, qualifications? If yes please give details below. *

Are you currently a member of another swimming club? *

If yes, please state your Swim England/ASA Number (or enter N/A if you selected "No" above) *

Please give details of any relevant medical conditions and medication required.

Volunteers aged 16 and over: You will be required to have a DBS check and you will receive an email about this on completion of this form. *

Volunteers aged 18 and over: You will be required to undertake a 90 min on-line safeguarding course within a reasonable time of starting with Phoenix. Details will be sent to you on completion of this form. *

The club may wish to take photographs of volunteers. All photos will be taken and published in line with the Swim England Photography policy.( If you are U18 we will need to have your parents permission) . Please tick those that you are happy to let us take and use.

I understand that my responses will be held by the Colchester Phoenix Lead Teacher and the Volunteer Co-ordinators. My data will also be shared with Swim England for membership and insurance. *