JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Phoenix Data Collection
To collect personal data on our poolside and in-pool volunteers.
Sign in to Google
to save your progress.
Learn more
* Required
Email
*
Your email
Title
*
Mr
Mrs
Miss
Other
Option 5
Forename
*
Your answer
Surname
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Address
*
Your answer
Postcode
*
Your answer
Preferred Contact Telephone Number (this should be a parent's number if under 16)
*
Your answer
Email address (this should be a parent's email if under 16)
*
Your answer
Emergency Contact Name
*
Your answer
Emergency Contact Telephone Number (must be different to phone number above)
*
Your answer
Position Applied for
In Pool Volunteer
Committee Member
Poolside Volunteer
Teacher/Coach
Clear selection
Please could you give the reason(s) that you would like to volunteer (or are currently volunteering) with Colchester Phoenix?
*
Your answer
Please give details of any previous experience of being in an environment with a child with additional needs.
*
Your answer
Please give a description of your swimming ability, including attendance of swimming club/lessons and level reached.
*
Your answer
Do you hold any current swimming teacher; swim coaching, rescue test, lifesaving or first aid, qualifications? If yes please give details below.
*
Your answer
Are you currently a member of another swimming club?
*
Yes
No
If yes, please state your Swim England/ASA Number (or enter N/A if you selected "No" above)
*
Your answer
Please give details of any relevant medical conditions and medication required.
Your answer
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.
*
Yes I understand this requirement
I already hold a DBS certificate obtained through Colchester Phoenix
I already hold a DBS and subscribe to the update service. I will bring my certificate to Phoenix.
Not applicable as I am under 16.
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.
*
Yes I understand this requirement
I already hold a current safeguarding certificate and will bring a copy to Phoenix
Not applicable as I am under 18
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.
photos to be used on the club website
photos/film to be used on the club facebook page
photos to be included in newspaper articles
filming for training purpose
photos taken by a professional photographer at events
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.
*
Yes
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
