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Seasonal Beach Lifeguards 2002

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Seasonal Beach Lifeguards 2002 Powered By Docstoc
					 RNLI LIFEGUARD
 VOLUNTEER ENROLMENT FORM

Thank you for your interest in RNLI Lifeguards.

The RNLI is the leading provider of Beach Lifeguard services across the country, and relies heavily on voluntary
contributions as well as a great deal of volunteer expertise in the provision of its life saving services. Volunteer
lifeguarding is a rewarding way of supporting full-time Lifeguards, developing your skills and competencies, and
fitting in patrolling when you are available to help. RNLI Volunteer Lifeguards enjoy the same standards of support,
training, education and equipment that comes with being part of the RNLI, and ultimately contribute to saving more
lives at sea.

To become an RNLI Lifeguard, you will need to meet the following minimum requirements:
    1. Hold a valid and recognised Beach Lifeguard Qualification
    2. Be compliant with the RNLI’s medical requirements (available on request)
    3. Complete a surf competency and fitness test, the requirements of which can be obtained on request or from
       the RNLI website (www.rnli.org.uk/lifeguards)
    4. Be at least 16 years of age. Any applicants aged under 18 years of age must complete a parental consent
       form (section 7)

It is recommended that you are a member of a Life Saving Club affiliated to either SLS GB or RLSS UK.

Please note that your application process will be looked after by an RNLI Volunteer Development Officer, however
your suitability and subsequent rostering and deployment as a Volunteer Lifeguard is at the discretion of the RNLI
Area Lifeguard Manager


 Area applied for / Club name


Section 1: Personal Details
 Surname:                                                  Title:
 Forename(s):                                              Gender:
 Known As (no nicknames):
 Date of Birth:                                            Age:
 Address:


                                                           Post Code:
 Home Tel Number:                                          Mobile Number:
 Email:                                                    Occupation:

Section 2: Emergency Contact Details
 Name:                                                     Relationship:
 Address:



                                                           Post Code:
 Home Number:                                              Mobile Number:
Section 3: Lifeguard Qualification
The RNLI will ensure that all necessary training over and above the Beach Lifeguard Award will be provided. To
become a Volunteer Lifeguard you will require a valid Beach Lifeguard Qualification, which will be in date until the
end of the season.

Please provide photocopies of your qualification certificates and return along with this form, or ensure that an
RNLI Volunteer Development Officer has seen your original certificates and signed this form before it is
submitted.

It is essential that you complete the expiry date column.


    Award/Governing Body                    Qualification (Date taken, where gained)                 Expiry Date




Section 4: Lifeguard Experience
Please enter details of any beach lifeguard or related experience below:
Section 5: Availability
The RNLI will look to the club to co-ordinate availability for patrols, however the Area Lifeguard
Manager will require notification in time to prepare a duty roster for the beach/area on a weekly basis.
Therefore some indication as to availability would be useful.

Date available from:

Please indicate your availability below:

    Mon          Tues         Weds         Thurs          Fri            Sat           Sun




Section 6: Driving Licence
For some volunteer lifeguard positions a driving licence may be required.

Do you hold a valid UK driving licence?      YES                NO


Section 7: Parental Consent
All applicants aged under 18 require parental consent, the following declaration must be completed and
signed by both parents or guardians:

We hereby give consent for our     son     daughter      ward        (please tick as appropriate)

Name                                                                           Date of Birth        /   /

to become a volunteer RNLI Lifeguard. We understand that this may involve him or her in arduous
activities in potentially hazardous conditions.


Signed                                                       Mother/Guardian         Date:          /       /

Signed                                                       Father/Guardian         Date:      /       /


(Due to the nature of this role and in accordance with the Children’s Act 1989, it is important that two
signatures are provided; if this is not possible please inform your ALGM / ALGS)
Section 8: Please ensure you read the following sections carefully and complete accompanying
paperwork where necessary.

Data Protection
We take our responsibilities under data protection seriously. These require us to explain how the data
you have provided on this form and other personal data that may be created in connection with your
enrolment may be used. Any data provided by you, or by any third parties such as a club officer, will be
used in connection with your enrolment only. Access to this data will be restricted to those responsible for
recruitment.

Personal data relating to your enrolment will be held securely for a period of six months from the date of
receipt of your form. Following this period it will be destroyed. If you are successfully appointed, relevant
information may be taken from this form and used as part of your record.

Disclosure of Criminal Records
Due to the nature of work undertaken by a volunteer RNLI Beach lifeguard this post is exempt from the
Rehabilitation of Offenders Act 1974. If your enrolment is successful you will need to complete a
Disclosure form from the Criminal Records Bureau (CRB) for England and Wales or their counterparts in
Scotland and Northern Ireland. We will only consider criminal records that affect the nature of the job
applied for. Details of our recruitment policy of ex-offenders are available from the HR department.

Medical Requirements
As a part of the enrolment process, you will need to complete the enclosed confidential medical
questionnaire. Please ensure all questions are answered and to ensure confidentiality return to our
Consultant Occupational Heath Physician in the envelope provided.

Section 9: Declaration (To be signed in all cases by applicant)
I certify that, to the best of my knowledge, the information I have given is accurate and that I am in good
health and fit to carry out the duties of the role for which I am applying I have informed my employer that I
will be volunteering for this role. I will undertake medical and eyesight examinations as required by the
RNLI and agree to follow the relevant guidance and policies applicable to this volunteer role. I fully
understand that this is a volunteer role and I am not an employee. I am reliable and trustworthy and will
help to maintain and preserve the reputation of the RNLI. I am aware of the Volunteer Commitment, the
Code of Conduct and the volunteer policies which have been explained to me and to which I commit and
agree to.

Signed:                                                                              Date: /       /




Section 10: Club Officer Recommendation (to be completed by authorised club committee member)

Applicant known to Club:                      YES            NO

Applicant recommended:                        YES            NO

Signed:                                       Date       /    /

Position in club:
      RNLI USE ONLY – AREA LIFEGUARD MANAGERS / SUPERVISORS / VOLUNTEER
      DEVELOPMENT OFFICERS TO COMPLETE BEFORE SENDING TO HR


Please note that it is an RNLI requirement that this fitness level is maintained throughout the season if you
are to remain an active volunteer. Your RNLI Volunteer Development Officer will oversee and guide you
through the fitness testing, to fit in as far as possible with your availability (for example within a club training
session etc).

                    Pool Swim Times                                      Beach Run Times
   200m                                             mins        200m                           secs
  400m                                              mins
  25m underwater & 25m
  surface swim (consecutively)                      secs


 Signed:                                                               Date:
 Title:
Medical Questionnaire
For RNLI Volunteer Lifeguards


 Guidance Notes

 This Medical questionnaire should be completed by applicants who have not worked for the RNLI before, have
 not worked for the RNLI in the previous season, or have answered YES to a question in the Medical declaration
 for returning lifeguards.

The RNLI has a duty to the public, its volunteers and its employees to ensure that its Lifeguards are fit for
purpose. The Lifeguards website contains a Medical Standards section which we advise you to read prior to
completing this questionnaire. If you do not have Internet access, a hard copy can be obtained by contacting the
RNLI’s HR Dept on 01202 663362.

TO BE COMPLETED BY APPLICANT – PLEASE ANSWER ALL QUESTIONS IN BLOCK CAPITALS

    SURNAME:                                                  FORENAME:
    POST APPLIED FOR: VOLUNTEER                               LENGTH OF SEASON: N/A
    FULL-TIME            N/A                                  CASUAL       N/A

 Please list the jobs you have held in the past 5 years and give approximate dates (continue on a separate
 sheet if necessary)
                                                                            From            To




  Has your employment ever been terminated on the grounds of ill-health          YES             NO

  Approximately how many days / weeks sickness did you have:                     Last 12         12 months
                                                                                 Months          prior to that


  What is your height:                               What is your weight:
  Are you currently receiving any form of medical supervision or taking
  prescribed medication: (e.g. attending an osteopath, physiotherapy, hospital      YES               NO
  outpatients, taking regular medication?
  When did you last see your GP and why?



 Please send completed form, ensuring it is marked
 confidential, to the following address:

 For the Attention of the Consultant Occupational Physician
 c/o HR Department
 Royal National Lifeboat Institution
 West Quay Road
 Poole, BH15 1HZ
Pre-Employment Medical Questionnaire for New RNLI Lifeguards – Page 2
      Are you currently from or have you ever suffered from any of the illnesses listed
      below? (Please circle your answer)
1.    Heart trouble                                                    YES      NO

2.    High Blood Pressure                                              YES      NO

3.    Lung disease (e.g. Bronchitis, TB)                               YES      NO

4.    Stomach / Bowel Trouble                                          YES      NO

5.    Hernia or rupture                                                YES      NO

6.    Kidney or bladder disorders                                      YES      NO

7.    Jaundice / Hepatitis                                             YES      NO

8.    ME / Post Viral fatigue syndrome                                 YES      NO

9.    Joint problems                                                   YES      NO

10.   Back / neck problems                                             YES      NO

11.   Diabetes                                                         YES      NO

12.   Any allergies (e.g. Hay fever, Eczema etc.)                      YES      NO

13.   Asthma                                                           YES      NO

14.   Skin problems                                                    YES      NO

15.   Frequent / severe headaches or migraine                          YES      NO

16.   Severe stress reaction                                           YES      NO

17.   Depression / anxiety / other mental health problems              YES      NO

18.   Fits / faints / blackouts / epilepsy                             YES      NO

19.   Serious accident                                                 YES      NO

20.   Surgical operations                                              YES      NO

21.   Eye or sight problems                                            YES      NO

22.   Hearing or ear problems                                          YES      NO
Please comment if the answer to any of the above questions is “Yes”
    Pre-Employment Medical Questionnaire for New RNLI Lifeguards - Page 3

    PLEASE ANSWER THE SECTION ON EYESIGHT IN FULL

    The RNLI’s recommended eyesight standard for Lifeguards is currently 6/18, 6/18 unaided, correcting
    to 6/9, 6/9 using glasses or contact lenses.

       Would you have a problem meeting this standard?                                            YES           NO
       Do you currently wear:                             Glasses?                                YES           NO
                                                          Contact Lenses?                         YES           NO

       Have you ever had laser or other eye surgery?                                              YES           NO

    If the answer to any of the above is “YES”, you may be asked to attend an Optician for an eye test, at
    the RNLI’s expense.


    DECLARATION
    (To be signed by all applicants)

•    I understand that the RNLI requires information about the health of lifeguards to ensure their health, safety and
    welfare.

•     The information I have provided is accurate and I have not withheld any details. I understand that if, at a later
    date, it is discovered that I have knowingly withheld medical information, the RNLI may take disciplinary action
    against me, which may include immediate dismissal.

•     I consent to these data being processed and held by the RNLI Consultant Occupational Physician on a
    computer or manual filing system in accordance with the confidentiality requirements of the Data Protection Act
    1998 (Data Protection Act 1988 in the Republic of Ireland).


         Signed:                                                  Date:



    FOR USE BY THE CONSULTANT OCCUPATIONAL PHYSICIAN



                                                        If ‘no’, reason for decision
       FIT TO ACCEPT                    YES / NO


       SUBJECT TO REVIEW                YES / NO        Date of Review


       Date                             Signed
                                                             GP CONSENT FORM

                                         TO BE PRINTED AND COMPLETED BY ALL APPLICANTS
      Surname:                                                                    Address:

      Forenames:

      Date of Birth:

      Tel no. (inc. Code)                                                         Post/Area Code
      General                                                                     GP Address
      Practitioner:


  In order to clarify the information that you have given in the medical questionnaire overleaf it MAY be necessary for the RNLI
  Occupational Health Physician to apply to your doctor for a report. The content of any such report is confidential and made
  known only to the Occupational Health Physician. This consent relates only to a request to your doctor as part of the
  appointment process and will not be used later in any other context.
  Your rights under the Access to Medical Reports Act 1988 are summarised below.
  This Act applies in England, Wales and Scotland. There is similar legislation in place in Northern Ireland under the Access to
  Personal Files and Medical Reports (NI) Order 1991 and in the Isle of Man under the Access to Health Records and Reports
  Act 1993.
  Please read these rights carefully before you sign this form.
  You are entitled to:
  1. Withhold your consent to the RNLI making an application for a copy of your medical report to your doctor.
  2. Give your consent to the RNLI applying for a copy of your medical records but subject to you seeing a copy of your medical
  report before it is supplied to the RNLI’s Occupational Health Physician. You have 21 days from the date the report is
  requested, to view it before it is sent. If your doctor has not heard from you in writing within 21 days from the date of the report,
  then he or she will assume that you do not wish to see the report and that you consent to it being supplied. It is your
  responsibility to make the necessary arrangements with your doctor.
  3. When you see your report, if there is anything in it that you consider to be incorrect or misleading, you can make a written
  request to your doctor asking them to amend the report. If your doctor declines to amend the report, then you have the
  following options:
  a. To withdraw your consent for the report to be issued
  b. You can prepare a written statement setting out your views and ask your doctor to attach this statement to your report
  c. Agree to the report being issued unchanged.
  Note that your doctor is not obliged to show you any parts of the report that he or she believes:
 i. Might cause serious harm to your physical or mental health or to that of others or;
ii. Which would reveal information about a third party or would identify a third party who has supplied the doctor with information
   about your health unless that third party also gives consent. In the event of this happening your doctor will advise you of this
   and your access to the report will be limited accordingly.
  4. You may give your consent to the RNLI receiving a copy of your report indicating that you do not wish to see the report
  before it is supplied. In the event that you change your mind after the application is made and you notify your doctor in writing,
  he or she should allow 21 days after receiving that notice for you to have access to the report (provided the report has not
  already been supplied before you change your mind).
  You are entitled to have access to your medical report at any time up to six months after the report has been supplied. It is
  your responsibility to make the necessary arrangements with your doctor. Please also note that where a copy of the medical
  report is supplied to you, your doctor may charge a reasonable fee to cover the cost of supplying it.
  Declaration

  I understand why the RNLI is collecting this information and confirm that I have been informed of and understand my statutory rights under the
  Access to Medical Reports Act 1988. I hereby give my consent for the RNLI’s Occupational Health Physician to apply for a medical report
  from my doctor.
  I understand that this consent form will be copied to that doctor and shall have the validity of the original.
  I *do / do not (*delete whichever not applicable) wish to see my doctor’s medical report before it is sent to the RNLI’s Occupational Health
  Physician.


      Signed:                                                                  Dated:
Please return to the RNLI at the above address.

				
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