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Coach DirectoryCoach Details Form

Please complete this form to provide the necessary information required to be a registered coach for The Pony Club. Some sections are compulsory for legal requirements and details will be transferable to the Coaches Database.

Only those people listed on the Directory, who fulfil the necessary requirements (as listed on www.pcuk.org/training) are permitted to coach at Pony Club activities.

There is a charge of £5 per entry is required to add Coaches to the Directory.

Branch Officials are still able to add Coaches to the Directory themselves without incurring a cost.

Before you start, you will need to provide the following information, where relevant:

1. Details of the latest Continual Professional Development 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.

Friday 3rd November 2017 1

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 No: Security No:

http://www.pcuk.org/training


Please complete all sections required.

Section 1 – Personal Details TO BE COMPLETED BY ALLSection 2 – Qualifications TO BE COMPLETED BY ALL

Completion of Sections 3 – 8 depend on the Coach Category you should be in. Please follow the instructions in Section 2. Section 3 – Continuing Professional Development Section 4 – Disclosure CertificationSection 5 – Safeguarding and Protecting Children Workshop Section 6 – First AidSection 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

TYPE OF COACH Fully Accredited Supervised – Regular Supervised – Not Regular

Volunteer – Regular Volunteer – Not Regular Non Riding Visiting Coach

TITLE

GENDER

FORENAME

SURNAME

EMAIL*

DATE OF BIRTH

HOME PHONE

MOBILE PHONE

ADDRESS LINE 1

ADDRESS LINE 2

TOWN

COUNTY

POSTCODE PC COACHINGREGULARITY Per month: 4+ Days Less than 4 days

PREFERRED COMMUNICATION

Home Phone Mobile Phone Phone

Email Phone or Email Text OPERATING RADIUS OF HOME Miles:



GENERAL AVAILABILITY

All Week Weekdays Weekday Evenings Weekends

Weekday Evenings and Weekends School HolidaysENABLE OTHER BRANCHES/CENTRES TO SEE YOUR PROFILE?

Yes No

NOTES

PONY CLUB AREAS

BRANCH ASSOCIATIONS

CENTRE ASSOCIATIONS

*All Coaches must supply an email address.

SECTION 2. Qualifications

QUALIFICATIONS & DATES ACHIEVED

WHAT IS THE HIGHEST LEVEL YOU COACH FOR?

All levels E / D Test D+ / C Test C+ Test B Test B+ / AH / A Test

PREFERRED DISCIPLINE/S

General / All Dressage Endurance Eventing Games

Polocrosse Polo Pony Racing SJ Tetrathlon

WHAT IS THE HIGHEST LEVEL OF PONY CLUB TESTS YOU ASSESS FOR?

I’m not an assessor E D D+ C C+ B B+ AH A

ASSESSOR TRAINING ATTENDED Level/s and date/s taken:

CPD COURSES ATTENDED Course/s and date/s taken:

ARE YOU A BHS REGISTERED INSTRUCTOR?

Yes NoARE YOU A REGISTERED COACH FOR ANY OTHER EQUESTRIAN ORGANISATIONS?

British Dressage British Eventing British Showjumping

Endurance GB

ABRS RDA UK Polocrosse Other: ARE YOU A PONY CLUB RECOMMENDED COACH?

Yes No [Recommended Coaches are approved by the Training Committee and listed on www.pcuk.org]


http://www.pcuk.org/


You now need to identify which Coach Category you are. Please select one.

1. Fully Accredited Equestrian Coaches These Coaches can take sole charge of The Pony Club groups they coach, without supervision.Please complete Sections 3, 4, 5, 6 and 7.

2. Supervised Coaches These Coaches 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 7. If you coach regularly (i.e. four or more times within any 30 day period) also complete Sections 4 and 5.

3. Volunteer Coaches 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. If you coach regularly (i.e. four or more times within any 30 day period) complete Sections 4 and 5.

4. Coaches for non-riding / horse related activitiesThese Coaches 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 Coaches must attend a Pony Club CPD course at least once every two years.The only exceptions are:

BHS Accredited Professional Coaches may use some BHS CPD to count. Registered Coaches for other Equestrian Organisations may use their CPD from that

organisation but may only coach that discipline within Pony Club, if they are a coach for a specific discipline organisation. If they wish to coach other disciplines for Pony Club, they must attend a Pony Club CPD course.

PLEASE SUPPLY THE DATE OF THE LATEST PONY CLUB CPD COURSE YOU ATTENDED

If you are a BHS APC 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.

WHERE WAS THE COURSE HELD? WHAT WAS THE TITLE OF THE COURSE?

SECTION 4 – Disclosure CertificationFully Accredited and Pony Club 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 CERTIFICATION NUMBER PLEASE SUPPLY THE CERTIFICATE DATE OF ISSUE

*ARE YOU SUBSCRIBED TO THE DBS ONLINE UPDATE SERVICE?

Yes No Subscription to the online update service requires an annual fee

(£13 per year or free for volunteers)PLEASE CONFIRM THAT YOU HAVE SUPPLIED A COPY OF YOUR DISCLOSURE CERTIFICATE WITH THIS

Copy enclosed. This will be destroyed once it has been checked, in line with data protection legislation

SECTION 5 - Safeguarding and Protecting Children WorkshopThese should be attended at least once every three years. In the first instance, Coaches must attend a course in person and then can follow on with an online course but will need to then proceed with altering the two. Other courses which are accepted are Sports Coach UK and British Horse Society (BHS) courses.

PLEASE SUPPLY THE DATE OF THE WORKSHOP YOU ATTENDED

PLEASE CONFIRM THE TYPE OF COURSE ATTENDED

Face to Face OnlinePLEASE CONFIRM THAT YOU HAVE SUPPLIED A COPY OF YOUR CERTIFICATE WITH THIS FORM

Copy enclosed.



SECTION 6 - First Aid CourseThese 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) BHS Initial 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 BHS IFA EFAW / 1 day

coursePLEASE SUPPLY THE DATE OF THE COURSE PLEASE CONFIRM THAT YOU HAVE SUPPLIED A COPY OF YOUR CERTIFICATE WITH THIS FORM

Copy enclosed.

SECTION 7 – Coaches Folder (All Coaches)The Pony Club Coaches 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 COACHES FOLDER?

Yes No

Thank you for providing your information. This will be added to the Coach Directory within 7 days of receipt.

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:

Coach Name and Signature:

Date:

Please return this form to The Pony Club Office by email to [email protected] post (The Pony Club, Stoneleigh Park, Kenilworth, Warwickshire, CV8 2RW). Please keep a copy for your own records.


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