First and Last name as you wish it to appear on your certificate

In case we need to contact you about course arrangements or other related queries

Upon successful completion of the course we will add your details to our coaching database.  We use the coaching database to validate qualifications in the event of a query

Please provide the name of your club if different to that of your Association

You will need to practice your coaching skills and film yourself running a class. You therefore require the support of a QUALIFIED coach who can supervise your coaching sessions. They must be present at your filmed classes for insurance and duty of care purposes. Please give the name of the Instructor or Instructors from your club who will supervise you as a coach in training.

PLEASE LEAVE BLANK IF THE DATE HAS NOT YET BEEN FIXED

Please use this section to advise us of any particular needs you might have during the course. This might include e.g. dyslexia (please see separate question for medical issues). All information will be treated in confidence and used to provide any nececssary support.

This course requires a degree of physical activity and exertion. The practical assessment may be assessed remotely and so by agreeing below you are confirming that you do not know of any medical or health issues which could affect you during physical activity. You can find a screening form here which will guide you through a self-assessment process for participating in physical activity http://eparmedx.com/wp-content/uploads/2021/01/ParQ-Plus-Jan-2021-Fillable.pdf

The cost of the course is £20. Payment is due before you attend. When making your payment, please include your name as a reference

Please tick to confirm the followiing. If you cannot agree to these terms then you will not be able to attend the course.