DBSC Patrol Crew Application Form

DBSC Patrol Crew Application Form
Applicant Details:
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County
Post Code
Phone Number*
E-mail
example@example.com
Date of Birth

DayMonthYear
Date
Age*
e.g 18
PPS Number *
Do you suffer from any medical illness, allergies or carry medication on your person that we should know about*

YesNo
If you have answered YES to the above please supply details here
All information supplied will be treated in the strictest confidence
Qualifications and Availability
Qualifications*

Powerboat Level 2Safety BoatVHF Radio LicenceCurrent First Aid CertificateNational Powerboat CertificateSailing InstructorSafeguardingOther
Please upload certificate copies here, if you have not already provided them.

Any problems uploading your certificates please email dbscpatrolcrew@gmail.com
Cancelof
Have you worked for DBSC before?

YesNo
Availability during Season. Please state below holidays you may have already booked during the season

Please select your preferred days

	Days
Most preferred day
2nd
3rd
4th

I Declare I am over 18 years of age
Emergency Contact Details and Parental Consent

A Parent/Guardian Must Sign Below If Applicant is between the age of 16 to 18 yrs
Primary Emergency Contact
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship

ParentSiblingGuardianOther
If you are under 18 years of age, Parental consent must be given to DBSC and its agents so you may be contacted directly by electronic means such as Mobile phone, SMS, Email and Whatsapp
I, as Parent/Guardian give the above consent Signature
In case we are unable to contact the Primary Emergency Contact you have provided, please provide details of a Second Emergency Contact
Second Emergency Contact Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship

ParentSiblingGuardianOther
If you are under 18 years of age, Parental/Guardian consent must be given so that DBSC and its agents can contact you directly by electronic means such as Mobile phone, SMS, Email and Whatsapp
I, as Parent/Guardian give the above consent Signature
Safeguarding Statement

Over 18 years only
Have you recently been ISA Garda Vetted or have you applied for the vetting process?

YesNo
Data Protection Statement

Patrol crew are required to provide the above personal data to Dublin Bay Sailing Club
Do you consent to the collection of your data for the purposes of Dublin Bay Sailing Club organising rosters, work payments and to carry out Revenue Commissioners tax compliance and for Dublin Bay Sailing Club to use the contact information provided to contact you by email, SMS, phone or Whatsapp media for the purposes outlined above?*

YesNo
Do you give consent for your contact details being shared with the Sailing Managers of the Dun Laoghaire Motor Yacht Club, National Yacht Club, Royal Irish Yacht Club and the Royal St. George Yacht Club for the purposes of contacting you in regard to sailing events and regattas they are organising?*

YesNo
Should be Empty:

DBSC Patrol Crew Application Form

Qualifications and Availability

Emergency Contact Details and Parental Consent

Safeguarding Statement

Data Protection Statement