Sporting Memories Groups

Your contact details

Name*

First Last

Address*

Street Address City ZIP / Postal Code

Email*

Phone*

Please enter with a space between the code & number. (ie: 07654 123456)

Date of Birth*

DD/MM/YYYY

Next of kin / Emergency Contact Name*

Next of kin / Emergency Contact Phone*

Please enter with a space between the code & number. (ie: 07654 123456)

Safeguarding

We have a commitment to the safeguarding of children and adults with care or support needs.

DBS Check*

Have you had a DBS Check. Please select one of the choices below

Yes (within last 12 months)
Yes (more than 12 months ago)
No

Do you have any unspent convictions*

Please tick 'Yes' if you have any convictions that are not yet spent under the Rehabilitation of Offenders Act 1974. The term 'convictions' is used to refer to any sentence or disposal issued by a court. If all your convictions are spent, you can tick 'No'. If you're not sure if your convictions are unspent or spent, you can use a tool available at www.disclosurecalculator.org.uk and read guidance at hub.unlock.ord.uk/roa.

Yes
No

List 99 & DBS*

Have you ever been included on the List 99 or the DBS barred list that prevents you from taking part in regulated activity with children or adults? Has your name ever been included on the sex offenders register? Are you or have you ever been subject to a sex offender prevention order, or subject to any associated condition?

Yes
No

Do you hold a full UK Driving License?*

Yes
No

1st Referee*

Please give a name and contact number for a reference.

2nd Referee*

Please give a name and contact number for a reference.

Relevant Experience / Qualifications*

Please detail any relevant experience or qualifications you may have below.

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Email

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Elder Tree Volunteer (Sporting Memories)

Your contact details

Safeguarding

When submitting

We value your opinion