COACH/LUNGER/JUDGE REGISTER

All coaches / Lungers/Judges must complete the training register

Name:

I AM A COACH / LUNGER / JUDGE (Please circle)

I have gained the following qualifications and I have been awarded a certificate as evidence of my achievement (please tick):

LEVEL	FULL	VAULTING ONLY	LUNGING ONLY
Level 1
Level 2
Level 3

PLEASE NOTE: Full includes all additional courses attended (e.g. first aid/child protection/ NCF courses) as detailed on the coaching syllabi, which can be viewed at www.vaulting.org.uk/coaching.htm UKCC may require evidence in the form of certificates in order to release funding.

I have gained the following judging qualification (please tick):

LEVEL	YEAR
National candidate
National (P)
National
International candidate

I have attended the following courses in the last 2 years for continuous professional development. To be filled in by all

COURSE

DATE

MY FIRST AID QUALIFICATIONS ARE CURRENT YES /NO

Date due for renewal : Copy of certificate enclosed YES/NO

I agree to my information being held on the training register and I agree to my information being shared with BEF coach database. (Does not apply to judge information).

Signed:

e-mail:

Tel.

………………………………………………………………………………………………………….

Office use:

Checked

Date

Membership number