Coach/Instructor Registration Form

Please ensure all sections are completed fully and all relevant documents are attached. No coaching can take place if this form is missing any information. This form must be completed annually by all coaches. Name

Address

Tel. Mobile Email Which Sports Club will you be working with? C!"# MS"SSEES $delete as appropriate) Club Name% &lease tick i' you are a C! student%

Coaching #ate agreed with club% #ecommended N+, #ate

( (

per per

'or season )** "*

ll coaches/instructors !"#T be #elf$%mployed in order to receive payment. &lease attach a Sel'-employed declaration or include the 'ollowing statement on in.oices% I am self employed and I am responsible for any tax or National Insurance liability &ualifications - please pro.ide details
N+, A''iliation No%

Copy /ocuments attached?

0es

Without copies, no payments will be made

&ualifications 'National (overning )ody * other relevant+

/ate passed

Insurance - please pro.ide details

Copy /ocuments attached?

0es

Without copies, no payments will be made

1ssuing ,ody"Company

/ate o' Commencement

/ate o' e2piry

,ata Protection ct -../ 0 This in'ormation is being collected 'or the purposes o' 3ealth 4 Sa'ety. 1t will be retained 'or 5 years a'ter which time it will be destroyed. The in'ormation gi.en will not be passed on to any other organisation.

First id Copy /ocuments attached?

0es

No

/ate o' e2piry

Coach$Club Commitment &lease attach an additional sheet6 signed by yoursel' and the club6 summarising the details that ha.e been agreed with the Sports Club. This shall include% Coach Club 7 no. o' coaching hours per week 7 club responsibilities 7 the days o' deli.ery 7 aims 'or the season 7 type o' training 7 plus other areas you 'eel are rele.ant 7 teams"s8uads to be coached 7 coaches responsibilities 7 aims 'or the season

Referees &lease pro.ide details o' two re'erees6 ideally related to recent coaching posts or appointments. #e'erences will be taken up by the Club &resident. Name Address Tel. No. Email Address #elationship to you Name Address Tel. No. Email Address #elationship to you

1 hereby certi'y that 1 ha.e read the C! nion Coach"1nstructor Code o' &ractice and hereby agree to abide by its content and spirit. Signature /ate

Please return this form to the Club President 1ho 1ill return it to "C2 "nion. Please make sure you attach copies of all 3ualifications and insurance details Please note "C2 "nion reserves the right to confidentially survey our members about the performance of coach/instructors as 1ell as to observe sessions 1ithout notice

,ata Protection ct -../ 0 This in'ormation is being collected 'or the purposes o' 3ealth 4 Sa'ety. 1t will be retained 'or 5 years a'ter which time it will be destroyed. The in'ormation gi.en will not be passed on to any other organisation.

"C2" FIN NC% ,%P RT!%NT

4th Floor 56 (ordon #treet 2ondon 7C-8 9 : &"%#TI;NN IR% R%( R,IN( %!P2;:!%NT #T T"# $&art A to be completed by the indi.idual to be considered as sel'-employed i.e. by the coach"instructor9 P RT 0 Personal ,etails Name0 National Insurance Number% ,ate of )irth0

Full )usiness ddress0

&lease gi.e the name6 address and re'erence o' the ta2 district to which the indi.idual submits ta2 returns%

#ignature0 ,ate0

$&art , 4 C to be completed by Club &resident9 P RT )0 "C2" ,epartment/Club ,etails "C2" department/Club Name0 C! &arkour Club Person and <ob title for 1hom the 1ork is undertaken0 :ason Cheung6 C! &arkour Club &resident Name and <ob title of the person to 1hom the self employed individual is responsible 'if different from above+0

;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;

P RT C0 7ork ,etails

,ata Protection ct -../ 0 This in'ormation is being collected 'or the purposes o' 3ealth 4 Sa'ety. 1t will be retained 'or 5 years a'ter which time it will be destroyed. The in'ormation gi.en will not be passed on to any other organisation.

Is the individual 1ho is carrying out the 1ork already on the payroll as an employee 'including permanent= fi>ed term or any other appointment+? If so= please provide <ob title and department. No ,oes the person carry out 1ork solely for "C2"? No

Is there a 1ritten agreement or contract? If so= please provide a copy. If not= please supply copies of any relevant correspondence.

7hat is the nature of the 1ork undertaken? Please provide as much detail as possible. Coaching o' an outdoor &arkour lesson6 including warm ups6 warm downs6 demonstrations6 'eedback etc.

8o1 long 1ill the assignment last? Please provide start and end dates. <"<*"<=-)5"="<>

8o1 often is the 1ork carried out? i.e. number of hours= days and fre3uency. Two hours in one session e.ery week

7hat payments have been made in the last t1elve months? Please list dates and amounts. None

8o1 much is being paid for this assignment? (=*"hour

,ata Protection ct -../ 0 This in'ormation is being collected 'or the purposes o' 3ealth 4 Sa'ety. 1t will be retained 'or 5 years a'ter which time it will be destroyed. The in'ormation gi.en will not be passed on to any other organisation.

re there likely to be any further assignments? payments are likely to be made. Not beyond the weekly session

If yes= please provide details including 1hat

7here is the 1ork carried out? &arkour hotspots6 such as ?ing@s Cross6 Chalk Aarm and Archway

7ho decides 1here the 1ork is carried out? :ason Cheung

7hat e3uipment is re3uired to carry out the 1ork and 1ho provides it? Please provide a list of all ma<or items and give a breakdo1n of 1ho provides it. No e8uipment is needed

7hat supervision is given by "C2" employees/clubs or societies? Please provide full details and fre3uency of supervision. None

7hat is the nature and e>tent of the control 1hich "C2" are entitled to e>ercise over the 1ork of the individual? 'If not fully e>plained above+.

Is the individual able to decide 1hat 1ork is necessary to achieve the ob<ective set and 1hen it is carried out= provided that the deadline is adhered to? 0es

,oes the individual have to correct unsatisfactory 1ork in his/her o1n time 1ithout additional payment? 0es
,ata Protection ct -../ 0 This in'ormation is being collected 'or the purposes o' 3ealth 4 Sa'ety. 1t will be retained 'or 5 years a'ter which time it will be destroyed. The in'ormation gi.en will not be passed on to any other organisation.

,oes the individual have a contractual obligation to send along a substitute 1orker if he/she is unable to do the 1ork him/herself? If so 1ho has to pay the substitute?

Can the individual hire other helpers if he/she considers it necessary to complete the 1ork= 1ithout e>tra payment by "C2"?

;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;; ;;;;;;;;;; uthorisation0 $to be signed by Club &resident and Treasurer9 Is your "C2" Club 1illing to meet the ta> charges and any penalties if the Inland Revenue decides at some future date that the above arrangements do not constitute self employment? #ignature of "C2" Club President0 Signed% &rint Name% #ignature of budget signatory 'if different from above+0 Signed% &rint Name% &!EASE #ET #N CBM&!ETE/ AB#MS W1T3 A!! S &&B#T1N+ /BC MENTS AN/ T3E C! , CBAC3 A+#EEMENT To CSC #eception6 )nd Aloor ,loomsbury ,uilding6 <C +ordon S8uare6 !ondon6 WC<3 *A3 /ate% /ate%

,ata Protection ct -../ 0 This in'ormation is being collected 'or the purposes o' 3ealth 4 Sa'ety. 1t will be retained 'or 5 years a'ter which time it will be destroyed. The in'ormation gi.en will not be passed on to any other organisation.