Coaches Registration Form Please complete and submit. "*" indicates required fields Coach InformationCoach Name* First Last Email* Enter Email Confirm Email Address* Address Suburb/Town Post Code Parent Email* (required if Coach is under 18 years) Enter Email Confirm Email Mobile*Date of Birth* Day Month Year Gender*Please SelectFemaleMaleWhich local government do you reside in?* City of Canning Town of East Fremantle City of Melville City of South Perth Town of Victoria Park Other Are you a new or returning Coach?* New to the Club Coached previously Which Grade?*Which Grade will you be coaching?Please SelectSuper League /DivisionsJunior LeagueSpikeZoneVolleyball WA Platinum or Technical Contact Code Number*Please enter your Volleyball WA Platinum or Technical Membership Contact Code Number in the field below. Your Contact Code Number can be found on the VWA Fortix website, when logged in look under 'My Profile' for Contact Code. Please complete this VWA registration prior to completing this form. > FORTIX LINK Working With Children Check - Number*Please enter your Working With Children Check (WWCC) Number. Working With Children Check - Expiry*Please enter your Working With Children Check (WWCC) Expiry Date. Reds Coaches Handbook*Have you read and understand the Reds Coaches Handbook? Yes No Agreement of Club Policies*Have you read, understand and agree to comply with the approved Club policies and Reds Code of Conduct that are available in the download section of the Coaches Portal? Yes No Reds Membership Agreement* I have read and agree to comply with the Reds Membership Agreement.Referee Accreditation Level* Level 1 Level 2 Level 3 No Accreditation Coach Accreditation Level* Level 1 Level 2 Level 3 No Accreditation Regional Travel Requirement*I am aware that if Bussleton Volleyball Club enter a team in my grade I will be required to travel to Bussleton to play a fixture. Yes Planned Absence from the Reds*Will you be absent from trainings and/or matches throughout the season? Yes No Please complete the Reds Planned Absence Form to provide the Committee and Reds coaches with an idea of the weeks throughout the year that you may be absent from the Reds. Statement by a Supplier*Please download the Statement by a Supplier form. Complete the form and tick “made in the course or furtherance of an activity done as a private recreational pursuit or hobby." The completion of this form is a requirement to receive your honorarium. Download Statement by a Supplier Form Once complete please upload here. Max. file size: 256 MB.Please provide the following bank account details to allow the Reds to transfer an honorarium to recognise you for your coaching at the end of the season.Account Name:* BSB* Account No.* Which Club will you be coaching?*Please SelectReds Volleyball ClubReds Junior Volleyball ClubWhich RVC team have you been selected to coach?*Please SelectLeague - MenLeague - WomenReserves - MenReserves - WomenDivision 1 - MenDivision 1 - WomenDivision 2 - MenDivision 2 - WomenDivision 3 - MenDivision 3 - WomenDivision 4 - MenDivision 5 - MenWhich RJVC team have you been selected to coach?*Please SelectDivision 1 Men (RJVC)Division 1 Women (RJVC)Division 2 Men (RJVC)Division 2 Women (RJVC)Division 3 Men (RJVC)Division 3 Women (RJVC)Coaches Shirt*Please Select your SizeXSSMLXL2XLCoaches Shirt*Please Select your size81012141618First Aid Training*Have you completed First Aid Training through St. John Ambulance or another organisation? Yes No Medical ConditionsPlease detail in the section below any medical history that you would like the Association aware of (eg. allergies, asthma, epilepsy, heart condition, pre-existing or recurring injuries that require monitoring, or any other medical matter that requires the Association’s attention).Photo Permission*I give Reds Volleyball Club permission to take photographs of me. I grant full rights to use the images resulting from the photography/video filming, and any reproductions or adaptations of the images for fundraising, publicity or other purposes to help achieve the Club's aims. This might include (but is not limited to), the right to use them in their printed and online publicity, social media, press releases and funding applications. Yes No Emergency ContactName First Last Email MobileCAPTCHA
