FORM FOR IBF/BCSA COACHES/INSTRUCTORS REGISTRATION
March 28th 2010 Fee £95 This allows you to Coach IBF Members only
Commercial Coach Fee £130 This allows you to coach members of other organisations
expires March 27th 2011
All questions to be completed fully in block capitals. All Coaches/Instructors must be registered with the Criminal Records Bureau, have a recognised First Aid Certificate and hold a valid Coaching Qualification or Instructors Certificate of Competence
Limit of Indemnity £5million
Please Note :
Insurance will not commence until a correctly completed and signed proposal
form and your cheque is received by our insurance broker Worldwide Sports
Insurance Uk Ltd . All cover is subject to the terms, conditions and exceptions
of the master policy held by our broker and is available for inspection upon
request. Please read the following declaration, sign at the bottom and return
this form, together with your cheque.
Declaration: I
declare that to the best of my knowledge and belief there are no known incidents
or circumstances that might give rise to a claim.
Signed ... ... ... ... ... ... ... ... ... ... ... ... ... ... .. Date ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .
You can pay over the internet via Internet Banking or Paypal or Cheque
Please send form via Email when possible IBFBCSA@googlemail.com
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Surname |
Christian (First) Name |
Address |
Town |
CountyPO Code |
Date of Birth |
Club |
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| Qualification or Certificate | First Aid Certificate | Years of Coaching | Martial Arts Grade if any | e.mail | Tel No | other relevant information | |||||||||||||||||||||
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