RLSS - Lifesavers

Lifesaving Instructors(APL) Course 6thMay 2017

PurposeTo qualify members of the RLSS UK who currently hold the approved prior learning qualification of Rookie Lifeguard Instructor with the skills required to deliver the Survive & Save Programme, and the Community Outreach Programme.

Pre-requisitesAged 17 or over

Life support 3

RLSS UK Membership

Hold or have held Heritage Bronze Medallion or higher, or a Silver Level Survive & Save Award or higher

Rookie Lifeguard status

Course Organiser Debbie Weston and Teresa Myatt

07775771450

DateSaturday 6th May 2017

Time -10.00 to 7pmapprox.

VenueLower Wick Swimming Pool, Lower Wick, Worcester, WR2 4AY

Cost£75.00 Cheques to be made payable to RLSS Hereford and Worcester Branch

ApplicationsA completed application form plus course fee (no cash via post please) and a copy of pre-requisites to be returned to:

Mrs D Weston

Perry Lodge

Old Hill

Flyford Flavell

Worcester

WR7 4DA

Items Needed:1. Swimming kit.

2. Pool side uniform (shorts & t-shirt)

3. Writing material. (May wish to make notes)

4. Lunch. Including mug

5. Proof of ID for DBS form

Teaching manuals will be issued on the day.

For more information regarding the course please contact me on the above mobile number.

Confirmation of course application and place on the course will be sent out once application is received.

If the course is over sub-scribed those not successful in gaining a place will be

notified at least 14 days before the course date and a full refund will be issued.

During the day DBS forms will be completed.

Please note that this course may be cancelled if there are insufficient enrolments. In the event of cancellation, a full refund will be issued.

Candidate Cancellation Policy

Please note the following cancellation policy applies:

-cancelled less than 14 days prior to the start of the course – a full refund will be issued minus a £10 administration fee

-cancelled less than 7 days prior to the start of the course – no refund will be given except in the event of illness / injury (for which a Doctor’s note must be provided) or exceptional circumstances

Closing date for applications 29thApril 2017

RLSS - Worcestershire & Herefordshire Branch

RLSS – Lifesaving Instructors Application Form

FULL NAME:-______

ADDRESS:-______

______

D.O.B.:-.______TELEPHONE NUMBER: - ______

EMAIL; ______

SIGNATURE:-______DATE: - ______

Society Number (if applicable):______Expiry Date:______

Lifesaving Experience?: ______

Do you currently hold a DBS certificate?: YesNo

Special Requirements: It is important to disclose any health/medical or learning needs on application for the consideration of reasonable adjustments. Please note that a written statement or evidence will be required.

______

I agree to abide by the General Rules and Conditions for the use of the venue.

I understand that I take part at my own risk.

This booking is non transferable.

Course organiser reserves the right to amend the timetable to suit the needs of the course.

Data Protection Act (DPA) – Worcester & Hereford Branch will process your data and hold it data securely in accordance with the DPA. Data will be used to administer you as a candidate. Your express written consent to hold this date is required under the DPA, which by signing this form you are providing.

I understand that Worcester & Hereford Branch are not under any liability whatsoever in respect of personal injury, loss or damage, whilst attending this centre.

Print Name______Signed______Date ______

Admin ONLY

Payment Details – Amount / Date & initials
Confirmation of receipt / Confirmation of course placement