Your name Your email Subject Your message (optional) National Pool Lifeguard Qualification Enrolment Form Course Date Candidate Details Title Name Date of Birth Telephone Email Emergency Contact Details Name Telephone RLSS Membership Before starting this course, if you aren’t already a member of the RLSS UK, you need to set up a RLSS UK account, go to rlssuk.tahdah.me/account/registernew select ‘No’ and follow the instructions. For further support you can use the guide here. Society Number Gender —Please choose an option—MaleFemaleGender NeutralPrefer not to say HOW RLSS UK USE YOUR DATA By completing this form, you agree to RLSS UK and its limited company RLSS UK Enterprises Limited processing and storing your personal data for the purpose of fulfilling our contract to provide you with your award or qualification. We promise your personal data will only be used by RLSS UK, RLSS UK Shop and RLSS UK Qualifications UK Limited. We will keep your data safe and will never share it with other organisations without your permission. For full details of how we process and store your data please refer to our Privacy Policy that can be found at https://www.rlss.org.uk/privacy-policy. By completing this form, you agree to Oaklands Community Pool and Goto Leisure CIO (Charity that operates the pool) processing and storing your personal data for the purpose of fulfilling our contract to provide you with your award or qualification. We promise your personal data will only be used by Oaklands and Goto Leisure CIO. We will keep your data safe and will never share it with other organisations without your permission. https://www.oaklandspool.org.uk/privacy-policy/ Course Prerequisites All candidates must meet the following criteria before starting the course (please tick) Yes, I will be 16+ years of age on the date of assessment Yes, I can jump / dive into deep water Yes, I can swim 50 metres in no more than 60 seconds Yes, I can swim 100 metres continuously on front and 100m continuously on back Yes, in deep water, I can tread water for 30 seconds Yes, I can surface dive to the floor of the pool Yes, I can climb out of the pool unaided without using a ladder / steps where the pool design permits Special Learning Requirements Do you have any specialist learning requirements? ( E.g Do you extra time in exams at school?) —Please choose an option—YesNo Do you have a disability / medical condition? *please note a good level of vision and hearing is required for this course —Please choose an option—YesNo If you have answered yes to either of the above, please provide further details below on how we can assist with your learning: Declaration I declare that all of the information I have provided on this enrolment form is true and accurate. I understand that if I have failed to declare any specialist learning requirements at this stage, this may impact my ability to successfully pass the assessment and gain the qualification. Parent/Guardian agrees (if under 18)
