Name *

In submitting and completing this form I acknowledge that I have read and understood the VA12SC Instructor Code of Conduct, Operational Plan & Risk Management Policy, Member Protection Plan and Position Descriptions. recognise my duties and responsibilities as a coach and instructor at VA12SC.

First Name

Last Name

Phone *

(###)

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Date of Birth

US Format (Month/Date/Year)

MM

DD

YYYY

Instructor Qualifications *

Please select the Australian Sailing qualifications that you hold

Assistant Instructor

Instructor

Senior Instructor

Dinghy Racing Instructor

Working with Children Check (WWC)

First Aid

CPR

WWC expiry date

US Format (Month/Date/Year)

MM

DD

YYYY

Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone *

(###)

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General Practice *

I agree to arrive on time for my shift and notify the head coach if I am running late.

I agree to come prepared to execute my lesson plan, having read the run sheet for the day.

I agree to not use my phone at any point throughout my shift. Phones will be left behind the canteen upon arrival for your shift.

I agree to actively coach the sailors when out on a rib at all times. No rafting up of coach boats.

I agree to always wear a lifejacket and take a working radio when going on the water, both sailing and on a rib.

I agree to accurately record my hours worked (inclusive of late arrival) and ask the head coach before signing off.

I agree to use appropriate language when working with children, i.e. no swearing.

I agree to prevent harm or endangerment of the sailors by not exposing them to dangerous or unsafe situations whereby hazards could/may result in injury.

Protect and preserve club property *

I agree to demonstrate and teach proper sail and boat care. Including washing and draining all boats of water at the end of each sail session.

I agree to not drag or put PJs on the beach or deck without a cradle.

I agree to ensure ribs are tied in a position where they will not drift under the deck or be damaged by oysters.

I agree to flush motors on the ribs at the end of each session.

I agree to report and attend to any damage or maintenance work of boats or ribs on the maintenance log.