/booking%20form

Workshop Application Form Workshop Details Which workshop are you applying for?

Supporting Parents to Support you

Dealing with Challenging Behaviour (10­16yrs)

Dealing with Challenging Behaviour for u10’s

Nutrition and Exercise for Children in Sport

Workshop Date: (DD/MM/YY)

Workshop Venue:

About You Full Name

Address

Postcode

Contact number (home)

Contact number (work)

Contact number (mobile)

Email address

Date of birth (DD/MM/YY)

Please only fill in fields that you are happy for us to use as a means of communication.

Please tick the appropriate box to indicate your gender:

Male

Female

Ethnic origin

(Please tick the appropriate box to indicate your cultural background):

White ­ British

Asian or Asian British ­ Bangladeshi

White – Irish

Any other Asian background

Any other white background

Black or Black British ­ Caribbean

Mixed ­ White and Black Caribbean

Black or Black British ­ African

Mixed ­ White and Black African

Any other black background

Mixed ­ White and Asian

Chinese

Any other mixed background

Prefer not to state

Asian or Asian British ­ Indian Asian or Asian British ­ Pakistani

Any other (please write in)

The Disability Discrimination Act 1995 defines a disabled person as anyone with a ‘physical or mental impairment that has a substantial and long­term adverse effect upon his/her ability to carry out normal day­to­day activities’. Do you consider yourself to have a disability?

Yes

No

If yes, what is the nature of your disability? (Please tick the appropriate box) Sensory impairment (including visual and hearing)

Learning disability

Physical impairment

Multiple impairments

Mental health difficulty (e.g. severe depression, bipolar)

Do not wish to answer

Do you have any special needs of requirements that the tutor should be aware of before the course i.e large print, hearing loop etc?

Yes If yes, please specify:

No

What is your main involvement in sport? (i.e coach, player etc)

What is your sport?

What qualifications do you hold?

Please provide details of how you heard about this workshop (i.e club development officer, website etc)

Payment method Payment must be made no later than 2 weeks prior to the training start date. Please check with your finance department regarding procedures for payment of this course. If any details for this are incorrect, and delays payment, an admin charge of £20.00 will be added to your fee.

BACS Cheque (made payable to Sport and Health Unite Ltd) Invoice my organisation Purchase Order Number / Reference Code: Details of person to be invoiced (including email address):

Please sign and date to confirm you agree with the Terms & Conditions and to validate this booking: Signed: ____________ ___________________________ date: Trainee’s Signature Signed: ____________ ___________________________ date: Manager’s Signature

(Please return booking forms 10 days prior to the qualification)

Sport and Health Unite Ltd would like to email you from time to time to keep you updated with other trainings we think may be suitable for you. Please tick here if you would prefer us not to do this

Thank you for your cooperation

Terms and Conditions Booking To make a booking simply complete the application form and return via email to enquiries@shultd.com . Alternatively our postal address is; Sport and Health Unite Ltd, Williamson House, 1 Bullfinch Close, Dovercourt, Harwich, Essex, CO12 4WH (Please return booking forms 10 days prior to the qualification) All booking forms must be signed by the trainee and their manager in order to be valid. Once the completed booking form has been received a letter of confirmation will be sent out to the trainee with dates, times & venue details.

Transferring Bookings The following charges apply if you wish to transfer your booking to a later course date: At any stage after the booking has been made ­ 10% Admin charge; 2 weeks prior to the course start date ­ 25% Admin charge; 1 week prior to the course start date ­ 50% Admin charge.

This option only applies to trainees wishing to transfer to a different date on the same course. The option to transfer trainees can only be used once, after which any movement will be considered a cancellation and any outstanding invoices will remain due.

Substituting trainees If you wish to substitute a place to a different trainee then please notify Sport and Health Unite Ltd at least 1 week prior to the training start date. The first change is free and thereafter there will be a 10% admin charge.

Cancellations Cancellations must be received in writing or via email to:­ enquiries@shultd.com and must contain the full booking details, including organisation name, booking & trainee contact details and invoice number. Verbal cancellations will not be accepted.

Cancellations must be submitted 1 month prior to the training start date in order for a full refund to be given. Failure to do this will mean that the full amount will still be outstanding and chargeable.

If a trainee fails to turn up on the day then the full amount will still be chargeable. In exceptional circumstances this fee may be waived at the discretion of the directors. In such circumstances, write to the directors giving full details of why you were unable to attend, enclosing any supporting documentation eg a doctors note.

Sport and Health Unite Ltd reserves the right to cancel any training 1 month prior to the training start date and is unable to accept responsibility for any costs incurred.

When a training is cancelled due to circumstances beyond Sport and Health Unite Ltd’s control (eg snow) then a different date will be made available for the training.

Payment Please check with your finance department regarding procedures for payment of this course. If any details for this are incorrect, an administrative charge of £20.00 will be added to your fee.

Payment must be made 3 weeks prior to the training start date.

Payment can be made via BACS payment.

Payment via BACS must go to: Account Name: Sport and Health Unite Ltd Bank: Co­operative Account Number: 68118125 Sort Code: 08­92­50 Please send a remittance advice form or email: enquiries@shultd.com and quote invoice number, date invoice paid and total amount when making a payment via BACS or Cheque.

Data protection Sport and Health Unite Ltd will use the information you provide on your booking form and any additional information you provide in the future for administering the training courses. Sport and Health Unite Ltd will not disclose this information to any other person or organisation, except in connection with the above purpose. All trainees are provided with a list of their co­ trainees’ names and organisations, but no further details are given out.

Further information If you require any further information then please contact Sport and Health Unite Ltd, Williamson House, 1 Bullfinch Close, Dovercourt, Harwich, Essex, CO124WH or email enquiries@shultd.com