West Yorkshire Winter School Games 2014 Volunteer Form Friday 14th March Leeds Metropolitan ni!

!ersity" #eadin$ley %ampus &'4(am 4'00pm )appro*+,

Dear Volunteer Please answer all the questions below. We are requesting information about you or your child(ren) in order to ensure that all people including volunteers involved in the West Yor shire !chool "ames (WY!") are as safe as possible. You will be sent additional event details on completion of the form. #he Data Protection $ct %&&'( #his form will only be used to collect information for the )ocal $uthority* West Yor shire !port and !port +ngland for pro,ect management* development and audit and will be used for those purposes only. Volunteer -ame( $ddress( Postcode( .obile( $ge( !chool01ollege02niversity (if applicable3)( -mer$ency contact . medical in/ormation' +mergency contact name( 4ome number( Do you consider yourself to have a disability3 5f so* what is the nature of the impairment3 (e.g. visual* physical* etc.3)( Do you have any medical conditions that we should be aware of3 $ny other relevant information (e.g. dietary requirements* medication3)( Media photo$raphs .edia photographs may be ta en at the West Yor shire !chool "ames. 5f you do not wish you photograph to be ta en and used in promotional materials please let West Yor shire !port now well in advance of the event. .obile( +mail( Date of /irth(

What is your ethnicity (please highlight or circle) for monitoring purposes only: White /lac 6ther /angladeshi /lac /ritish 5ndian 1hinese /lac 1aribbean /ritish $sian +ast $frican /lac $frican Pa istani $sian

6ther( 777777777777777777777777777777777777777777777777777777777777777777 Please list any current 0 previous e8perience volunteering 0 wor ing with young people( -*perience 0osition 1oach04elper0#eam manager 01haperone06ther 9 Start 1ate

Volunteering at the West Yor shire !chool "ames involves wor ing with children and we are committed to the welfare and protection of children. 4owever* as this event is a one:off* you are not required to underta e a D/! chec (previously 1;/). $s part of our volunteer recruitment policies* we require you to supply a reference who can confirm your suitability and capability as a volunteer. ;eference -ame( Position( #el -o( +mail(

5 agree to inform you the event organiser of any changes to the above information. !ignature( Parents !ignature (if under %' years of age)( 2hank you /or your co3operation in completin$ and returnin$ this /orm 4S40+ Please return to( $my 1row* Development 6fficer West Yor shire !port #el( <%%= =&=&&>< +mail amy.crow?wysport.co.u www.westyor shiresport.co.u Date(