Winter 2019 Beaumaris Sharks Basketball Coach Registration
As the coach of a Sharks team we require you to complete the following information. This information is treated as confidential by the Club and is only used to: assist us in meeting our requirements under the Child Safety Act and inform our programs designed to support Sharks coaches in their important volunteer role.
The season you are coaching is *
Age Group of your team *
Boys or Girls? *
Name of Team *
Your answer
Your name (as stated on your Working With Children Check card) ** if coach is under 18 then name and WWC details of adult supervisor is required *
Your answer
Your email address *
Your answer
Your Working With Children Check card number *
Your answer
The WWCC card expiry date *
Have you completed any certified coach training? *
If you answered yes above, what training have you completed?
Would you be interested in receiving some assistance with coaching, either at training or during a game? *
Do you have a coach's bag? *
If you don't have a coach's bag, would you like one? *
Please read and note: The Beaumaris Basketball Club has a duty of care to all those associated with us. As a requirement of the Club's Member Protection Policy, the Club must enquire into the background of those who undertake any work, coaching or regular unsupervised contact with people under the age of 18 years.
Please read and make the MEMBER PROTECTION DECLARATION below: As a coach with the Club I sincerely declare: 1. I have never been charged with any criminal offence relating to child sexual abuse. 2. I am currently not the subject of any charge of a criminal offence relating to narcotics, violence or abuse including sexual abuse which has not yet been dealt with by the Courts. 3. I have not been found guilty by a Court of a criminal offence relating to narcotics, violence or abuse including sexual abuse. 4. No person has ever sought or obtained any intervention order, injunction or other restraining order against me alleging verbal or physical abuse (including sexual abuse). 5. I am not currently the subject of any sanction issued by a basketball association against me which prohibits me from holding a position of the type set out in clause 1 above. 6. No application submitted on my behalf has been rejected for, nor have I been suspended or dismissed from, a position in sport, volunteer organisation, business, educational or other Government or semi-government organisation where that rejection, suspension or dismissal relates to my conduct with persons aged under eighteen (18) years of age or to violence or drug use. 7. There are no other matters, which a reasonable person would consider relevant to the fitness of a person to be a coach of a team of players aged under eighteen or an administrator with frequent contact with persons aged under eighteen. 8. I will notify the President or CEO of the organisations appointing me to my position immediately upon becoming aware that any of the matters set out in clauses 2 to 6 above has changed for whatever reason.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.