Therapist Registration Form

Osteo Adventures - Registration Form

Qualified Therapists
This application form is to join the Osteo Adventures team. We use this to collect all the informtation needed to take part in any of our events.

To apply for a specific event please visit the events section of the website and apply individually.
All information is stored in line with GDPR guidelines in the UK. Secured and locked away in our Google Drive, which is only accessed by the Osteo Adventures Team and Ultra X.
Name*

First NameLast Name
Photo ID*

Browse Files
E.g. Passport, Driving Licence Cancelof
E-mail*
Birth Date*

DayMonthYear
Phone Number*
For calls and WhatsApp
Do you want to join our Whatsapp group for event recruitment?
Address*

Street Address

Street Address Line 2

CityCounty

Post CodeCountry
Where did you hear about us?
Other
Therapist information
What therapist type are you?*

OsteopathSports RehabilitatorSports TherapistSports Massage TherapistPhysiotherapistChiropractor
Other
Governing body number: e.g. GOsC
Governing body registration certificate

Browse Files

Cancelof
I can confirm I have an active insurance policy to work as a therapist. *
When does my policy run out?*

MonthDayYear
Date
Insurance certificate upload*

Browse Files

Cancelof
I confirm I have a valid DBS or equivalent to work with children and vulnerable adults*
DBS or Equivalent upload

Browse Files
Photo or file Cancelof
I can confirm I have a valid first aid certificate*
First aid Certificate

Browse Files
Any issues contact us Cancelof
Emergency details
Next of Kin*

First NameLast Name
Phone Number*
Email*
example@example.com
Relationship to you*
Commitment to our team!
We work really hard to coordinate all of our event. All of us give up our time away from our clinical duties. The service we offer relies on our commitment and professionalism. The runners we work will be looking to us to help them perform at their best and get them to the finish line. A significant amount of time and training has gone into each runners preparation for these events and we need to ensure we have a full team.
By signing here I agree to the statement above and all information given is true to the best of my knowledge.*

Clear
To sign up for a particular events please see the events page and sign up form.

Please contact Kieran if you have questions on kieran@osteoadventures.com
Should be Empty:

Osteo Adventures - Registration Form

This application form is to join the Osteo Adventures team. We use this to collect all the informtation needed to take part in any of our events.

To apply for a specific event please visit the events section of the website and apply individually.

Therapist information

Emergency details

Commitment to our team!