LTA Instructor Registration Form Venue. Venue of course you wish to attend: * Start date of course you are applying for: * Personal Information. Full Name * First Name Last Name Email * Age on first day of the course * Date of Birth * Gender * Male Female Non Binary Prefer not to say Ethnicity White Asian or Asian British Black, Black British, Caribbean or African Mixed or multiple ethnic groups Any other ethnic group I prefer not to say Phone Number * Emergency Contact Name * Emergency Contact Number * LTA British Tennis Member No. (BTM) * Address for Postal Your Address * Your Address * City/Town * County * Postcode * Medical Information. So that the tutors can accommodate your needs, please indicate if you have any of the following: Asthma * YES NO Diabetes * YES NO Dyslexia * YES NO Epilepsy * YES NO Hearing Impairment * YES NO Use of a Wheelchair * YES NO Other, please specify: Additional Learner Information. How did you find out about this course? * What experience do you have of working with children? * What experience do you have of playing tennis? * What other coaching qualifications/ experience do you have that will help you on the course? Why are you doing the course? What are you intending to do after the course? Is there anything else you would like the tutors to know before the course? During the course you will be required to complete a minimum of 3 hours of coaching experience with a qualified licensed tennis coach. Please give the name of the coach and venue where this experience will take place. It can often be at the club where the course is taking place – just ask the coach/manager for more help. Don’t worry if you don’t know this information yet – you can always let us know later. Please give the name of the coach and venue where this experience will take place. Course Requirements. Please note that on day one of the course you need to show a photocopy of your current DBS Enhanced Disclosure (this used to be called CRB and is now called DBS). It must be valid for one year from date of issue. Alternatively, you can provide a signed copy of a ‘Deployment without DBS’ letter stating the dates and venue of the course you are applying for. A template letter can be found on the Growing The Game website: www.growingthegame.co.uk / Coach Education / Downloads. We will also send a copy in your welcome letter. The letter needs to be signed by a committee member, coach or Racquet Manager of the club where you plan to gain your coaching experience while on the course. Data protection. Growing The Game Ltd will only use your personal data, including sensitive personal data for coach education purposes, relating to the product you have purchased, which may include establishing a Unique Learner Number on your behalf with the Education and Skills Funding Agency. GTG will not give permission for this information to be used by any 3rd party (including the ESFA) for their own marketing purposes unless specified otherwise below. For further details please contact Nick Elliott at info@growingthegame.co.uk or on 07774 940474 . To help us develop coaches – Do you agree: (You will be able to change your consent at any time in the future) : Growing The Game Ltd may add your name and contact details to its secure database so you can receive GTG coach education information including offers for future GTG courses and CPD workshops by post, e-mail or SMS. * YES NO By clicking this box you are deemed to understand and accept the foregoing. I confirm that this application has been completed honestly and accurately. * I agree with terms and conditions. Thank you for completing your application for the Level 2 Certificate in Coaching Tennis. Your submission has been successful. We will get back to you as soon as possible! Read the Terms and Conditions.
