Girls United Coach Registration Form

Girls United Coach Registration Form
*Our database is refreshed on July 31st of each year in accordance to GDPR regulations. If you fill the form in between July 1st and July 31st, your information will be stored for the upcoming season and refreshed the following year.
Name*

First NameLast Name
Date of Birth*

DayMonthYear
Date
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Mobile Phone Number*

Country CodePhone Number
Do you wish to be added to the Girls United Coaches Whatsapp group?*

YesNo
Emergency Mobile Phone Number*

Country CodePhone Number
Emergency Contact Name*

First NameLast Name
Emergency Contact Relationship*
E.g. Parent, partner, sibling, etc.
Do you have any known health needs? E.g. Diabetes, asthma, epilepsy, allergies.*

YesNo
If yes, please specify and note if you require any specific medication and emergency care planning.
Where did you hear about Girls United?

From a friend / word of mouthOnline search through Google, etc.Social media (Facebook, Instagram, Twitter)Saw us training / playingOnline forumLocal news siteFlyer / PosterCoached with Girls United previouslyOther
Coaching Information
Highest Coaching Qualification
What is the highest coaching qualification you have attained?
Date of Completion

MonthDayYear
Date
Please upload the certificate for the coaching qualification referenced above.

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Safeguarding Children Course
Date of Completion

MonthDayYear
Date
Date of Expiry

MonthDayYear
Date
Please upload the certificate for your Safeguarding Children Course.

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First Aid Qualification
Date of Completion

MonthDayYear
Date
Date of Expiry

MonthDayYear
Date
Please upload the certificate for your First Aid Qualification.

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DBS
DBS Reference Number
Date of Issue

MonthDayYear
Date
Please upload your DBS check certificate.

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Additional Information
Order relevant qualifications or certificates.

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Girls United Onboarding
Can you confirm you received the Girls United Code of Conduct, Safeguarding Children Policy, Equal Opportunities and Coach Contract documents via email?

YesNo
Please upload a signed copy of the Girls United Code of Conduct to confirm you have read and agree.

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Please upload a signed copy of the Girls United Coach Contract to confirm you have read and agree.

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Payment Details

Please provide the following details to receive payments:
Please upload your completed HMRC 'Starter Checklist' which can be found via the link below.

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HMRC 'Starter Checklist': gov.uk/government/publications/paye-starter-checklist
Bank Account Name:
Bank Account Number:
Sort Code:
References

Please list two references including name, job title, contact number and email.
Reference 1
Reference 2
Media Consent
Without expectation of compensation, now or in the future, I hereby give my consent to Girls United FA and its affiliates to use an image/video of me and/or any interview statements from me in its publications, advertising or other media activities.

This consent includes, but is not limited to:
- Permission to interview, film, photograph, tape, or otherwise make a video reproduction of me and/or record my voice.
- Permission to use my name
- Permission to use quotes from the interviews, in part or in whole, in its publications, print media, and electronic media.
If you have any questions about media consent, please email hello@girlsunitedfa.org
I give my media consent to Girls United as per the terms stated above.*

YesNo
Do you consent to your name being used alongside your video/image/interview?*

Full nameFirst name onlyNicknameAnonymous
If you chose 'Nickname', please share your preferred nickname.
Optional Additional Information
What is your gender?

FemaleMaleNon-binaryTransgenderIntersexI prefer not to sayOther
What is your ethnic group?

WhiteMixed or multiple ethnic groupsAsian or Asian BritishBlack, African, Caribbean or Black BritishPrefer not to sayOther
How would you describe your ethnic background? Ethnic origin categories are not about nationality, place of birth or citizenship, they are about the group to which you as an individual perceive to belong.*
What languages do you speak and at what level? (Intermediate, advanced, fluent or native)
How your information will be used
We would like to keep your details so we can contact you about news from Girls United, for administration, recording and monitoring purposes, for marketing purposes and for any other purposes that Girls United considers reasonable. Your personal information will be held and used in accordance with EU GDPR 2018 and UK DPA 2018.

We may contact you by post, telephone, email or text.
Are you happy to be contacted by Girls United this way?*

YesNo
Signed:

Clear
Date

MonthDayYear
Date
Should be Empty:

Girls United Coach Registration Form

Coaching Information

Girls United Onboarding

Payment Details

References

Media Consent

Optional Additional Information

How your information will be used