Instructors Database
Instructor Details Form
This form is for you to provide the necessary information to comply with The Pony Club rules and
other legal requirements. While the Branch(es)/Centre(s) you coach for may have some
information about you stored on the Instructors Database, there will be some areas that are
missing, so the intention of this form is for you to provide that missing information. The fields found
on this form are the same as the fields required on the Instructors Database.
Only those people listed on the database, who fulfil the necessary requirements (as listed on
www.pcuk.org/training) are permitted to coach or instruct at Pony Club activities. The Pony Club
office provided a free data upload service until 30th April 2015 for coaches/instructors not yet listed
on the database. From 1st May 2015, a charge of £5 per entry is required to add further
instructors to the databases. Branch officials are still able to add instructors to the database
themselves without incurring a cost.
Before you start, you will need to provide the following information, where relevant:
1. Details of the latest Instructor Course (CPD) you have attended
2. Details of your disclosure check (DBS, CRB, PVG or Access NI) and a copy of your certificate
(this can be uploaded electronically as you go)
3. Details of the first aid course you have attended and a copy of your certificate (this can be
uploaded electronically as you go)
4. Details of the safeguarding course you have attended and a copy of your certificate (this can
be uploaded electronically as you go)
You may not be required to provide all of this information, depending on what level of coach you
are. If you don't have all of the information you are asked for, please just fill in what you can, but be
aware that you do not fulfil the requirements, you will not be eligible to coach until you are fully up to
date.
PLEASE ENCLOSE PAYMENT OF £5.00
Cheques should be made payable to The Pony Club or card details supplied below:
Cardholder name:____________________________________________________________________
Credit / Debit Card Number:
Start Date:
Expiry Date:
Issue No:
Security No:
Please return this form to The Pony Club Office by email (to training@pcuk.org) or post (The Pony Club, Stoneleigh Park,
Kenilworth, Warwickshire, CV8 2RW). Please keep a copy for your own records.
1
Instructors Database
Instructor Details Form
Please complete all sections required, as explained in the notes below. This form is used for you to provide
the necessary information to comply with The Pony Club rules and other legal requirements. While the
Branch(es)/Centre(s) you coach for may have some information about you stored on the Instructors
Database, there will be some areas that are missing, so the intention of this document is for you to provide
that missing information. The fields on this form are the same as the fields required on the Instructors
Database.
The Pony Club Office will upload the data gathered using this form for all instructors/coaches received by
th
Friday 27 February 2015 onto the Instructors Database, in order to achieve a complete list of Instructors
used for Pony Club activities. Once all of the data supplied has been added to the Instructors Database, only
those people listed, who fulfil the necessary requirements will be permitted to coach or instruct at Pony Club
activities.
Section 1 – Personal Details TO BE COMPLETED BY ALL
Section 2 – Instructor Record TO BE COMPLETED BY ALL
Completion of Sections 3 – 8 depend on the Instructor/Coach Category you should be in. Please
follow the instructions in Section 2.
Section 3 – Continuing Professional Development
Section 4 – Criminal Conviction Disclosure
Section 5 – Safeguarding and Protecting Children Workshop
Section 6 – First Aid
Section 7 - Instructor’s Folder (Fully Accredited coaches)
Section 8 - Instructor’s Folder (Supervised / Volunteer coaches)
Section 9 - TO BE COMPLETED BY ALL
SECTION 1. Personal Details
FULL NAME
ADDRESS LINE 1
ADDRESS LINE 2
TOWN
COUNTY
POSTCODE
EMAIL*
PHONE
MOBILE
*All instructors/coaches must supply an email address.
SECTION 2. Instructor Record
PRIMARY PONY CLUB AREA
PRIMARY BRANCH / CENTRE
This is the Branch/Centre/Area
you coach for most
IS
THIS
THE
ONLY
BRANCH/CENTRE
YOU
WANT TO COACH FOR?
1
2
3
4
5
6
7
8
9
11
12
13
14
15
16
17
18
19
Yes
10
No
Please return this form to The Pony Club Office by email (to training@pcuk.org) or post (The Pony Club, Stoneleigh Park,
Kenilworth, Warwickshire, CV8 2RW). Please keep a copy for your own records.
2
Instructors Database
Instructor Details Form
PLEASE LIST ANY OTHER
BRANCHES / CENTRES YOU
COACH FOR
WHAT DATE / YEAR DID YOU
BEGIN COACHING FOR THE
PONY CLUB?
Please estimate if unknown
WHAT IS THE HIGHEST
LEVEL YOU COACH FOR?
All levels
E / D Test
PREFERRED DISCIPLINE
Please select ONE only
General / All
Dressage
Endurance
Eventing
Games
Polocrosse
Polo
Pony Racing
SJ
Tetrathlon
WHAT IS THE HIGHEST
LEVEL OF PONY CLUB
TESTS YOU ASSESS FOR?
I’m not an assessor
E
D
D+
C
C+
B
B+
AH
A
C+ Test
D+ / C Test
B Test
B+ / AH / A Test
PLEASE
LIST
YOUR
COACHING QUALIFICATIONS
(if applicable)
ARE
YOU
A
BHS
REGISTERED INSTRUCTOR?
ARE YOU A REGISTERED
COACH FOR ANY OTHER
EQUESTRIAN
ORGANISATIONS?
ARE YOU A PONY CLUB
VISITING COACH?
DO YOU WISH FOR YOUR
RECORD TO BE GIVEN FULL
PRIVACY?
Yes
No
British Dressage
ABRS
Yes
British Eventing
RDA
British Showjumping
UK Polocrosse
Endurance GB
Other:
No [VCs are approved by the Training Committee and listed on www.pcuk.org]
If you request Full Privacy then you will not be visible in any searches performed by other
Branches, Centres or Areas. You will still be viewable to your primary Branch/Centre, the Area
Rep, and The Pony Club office. If you have requested Full Privacy, you must provide a reason
why.
No
Yes
Please state why if YES:
You now need to identify which Instructor/Coach Category you are. Please select one.
1.
Fully
Accredited
Equestrian
Coaches
/
Instructors
These Coaches / Instructors can take sole charge of The Pony Club groups they coach, without
supervision.
Please complete Sections 3, 4, 5, 6 and 7.
2.
Supervised
Coaches
/
Instructors
These Coaches / Instructors must not earn their main income from coaching riding. They may be paid to
coach for The Pony Club. They must be supervised (within full sight and sound at all times) by a Fully
Accredited Coach (category 1), the DC or Centre Proprietor, or any other official who fulfils the
requirements for category 1.
Please complete Sections 3 and 8. If you coach regularly (i.e. four or more times within any 30 day
period) also complete Sections 4 and 5.
3.
Volunteer
Coaches
/
Instructors
These Coaches / Instructors must be unpaid and supervised by a Fully Accredited Coach (category 1),
the DC or Centre Proprietor, or any other official who fulfils the requirements for category 1.
Please return this form to The Pony Club Office by email (to training@pcuk.org) or post (The Pony Club, Stoneleigh Park,
Kenilworth, Warwickshire, CV8 2RW). Please keep a copy for your own records.
3
Instructors Database
Instructor Details Form
Please complete Section 8. If you coach regularly (i.e. four or more times within any 30 day period)
also complete Sections 4 and 5.
4.
Coaches
/
Instructors
for
non-riding
/
horse
related
activities
These Coaches / Instructors can be used for coaching sports / disciplines other than riding for Pony Club
activities e.g. Swimming, Shooting, Running.
Please complete Sections 4, 5 and 6.
SECTION 3 - Continuing Professional Development (CPD)
Pony Club Instructors/Coaches must attend a Pony Club CPD course at least once every two years.
The only exceptions are:
 BHS Registered Instructors may use their BHS CPD
 Registered Coaches for other Equestrian Organisations may use their CPD from that organisation but
may only coach that discipline within The Pony Club, if they are a coach for a specific discipline
organisation. If they wish to coach other disciplines for The Pony Club, they must attend a Pony Club
CPD course.
e.g. BD registered coaches need not attend Pony Club CPD, but may only coach Dressage within The
Pony Club. If they wish to coach any other discipline, they must attend a Pony Club CPD course.
If you are a BHS Registered Instructor and haven't attended
Pony Club CPD, please supply the date of your latest BHS
CPD. If you are a Registered Coach for another organisation
and haven't attended Pony Club CPD, please supply the date
of your latest relevant CPD for that organisation.
PLEASE SUPPLY THE DATE
OF THE LATEST PONY CLUB
CPD
COURSE
YOU
ATTENDED
WHERE WAS THE COURSE
HELD?
WHAT WAS THE TITLE OF
THE COURSE?
SECTION 4 – Disclosure Check
Fully Accredited and Pony Club Instructors/Coaches who coach regularly must have an up to date enhanced
disclosure check. This should have been completed in the last three years. If the certificate contains any
information it must be reported to The Pony Club for consideration following The Pony Club’s procedure, in
order that the insurers can be informed and for the insurance to remain valid.
PLEASE
SELECT
DISCLOSURE TYPE:
THE
PLEASE
SUPPLY
THE
CERTIFICATE
DATE
OF
ISSUE
*ARE YOU SUBSCRIBED TO
THE DBS ONLINE UPDATE
SERVICE?
PLEASE CONFIRM THAT
YOU HAVE SUPPLIED A
COPY
OF
YOUR
DISCLOSURE CERTIFICATE
WITH THIS FORM
CRB
Yes
DBS*
PVG
Access NI
No Subscription to the online update service requires an annual fee
(£13 per year or free for volunteers)
Copy enclosed.
This will be destroyed once it has been checked, in line with data protection legislation
SECTION 5 - Safeguarding and Protecting Children Workshop
These should be attended at least once every three years. In the first instance, Instructors/Coaches must
attend a course in person.
If you are unable to attend a Pony Club Safeguarding and Protecting Children Workshop, Sports Coach UK
and British Horse Society (BHS) courses are also accepted.
PLEASE SUPPLY THE DATE
OF THE WORKSHOP YOU
ATTENDED
Please return this form to The Pony Club Office by email (to training@pcuk.org) or post (The Pony Club, Stoneleigh Park,
Kenilworth, Warwickshire, CV8 2RW). Please keep a copy for your own records.
4
Instructors Database
Instructor Details Form
PLEASE CONFIRM THAT
YOU HAVE SUPPLIED A
COPY
OF
YOUR
CERTIFICATE WITH THIS
FORM
Copy enclosed.
SECTION 6 - First Aid Course
These need updating every two or three years, depending on which course you do. The following courses are
accepted:
 First Aid at Work (expires after three years)
 Equine Specific First Aid Course (expires after two years)
 Emergency First Aid at Work, or any other one-day First Aid course including resuscitation (usually
expires after three years – check the date on your certificate)
PLEASE SELECT THE FIRST
AID COURSE TYPE:
PLEASE SUPPLY THE DATE
OF THE COURSE
PLEASE CONFIRM THAT
YOU HAVE SUPPLIED A
COPY
OF
YOUR
CERTIFICATE WITH THIS
FORM
FAW
ESFAC
EFAW / 1 day course
Copy enclosed.
SECTION 7 – Instructor’s Folder (Fully Accredited coaches)
The Pony Club Instructor’s Folder contains up to date information on Pony Club Tests, Health & Safety
policies and other relevant information. Fully Accredited coaches should own a copy.
DOYOU OWN A COPY OF
THE
PONY
CLUB
INSTRUCTOR’S FOLDER?
Yes
No
SECTION 8 – Instructor’s Folder (Supervised / Volunteer coaches)
The Pony Club Instructor’s Folder contains up to date information on Pony Club Tests, Health & Safety
policies and other relevant information. Supervised / Volunteer coaches should have access to a copy, either
at home or in the Branch/Centre.
DOYOU HAVE ACCESS TO A
COPY OF THE PONY CLUB
INSTRUCTOR’S FOLDER?
Yes
No
SECTION 9
Thank you for providing your information. This will be added to the Instructors Database in the coming weeks.
The Instructors Database is undergoing some improvements which will allow you to log in and maintain your own record,
so that you can ensure you are up to date and eligible to coach for The Pony Club. You will receive timely reminders by
email when your CPD, DBS, First Aid and Safeguarding dates are nearing expiration (if required). You will also be
contacted annually to ensure that your contact details and other personal information is up to date.
st
The facility for you to log in to the Instructors Database will be available from 1 October 2015. Your log in details will be
sent by email at this time. This means that there will be a short time between the data being added to the database and
the Instructors/Coaches being able to log in and update their own record. During this interim period, we would very much
appreciate it if you could inform your Branch/Centre of any changes or updates, so that your records are kept up to date.
Please sign below to confirm that all of the information supplied is, to the best of your knowledge, correct, and that you
have supplied the required certificate copies:
Instructor/Coach signature: ________________________________________________ Date: _____________________
Please return this form to The Pony Club Office by email (to training@pcuk.org) or post (The Pony Club, Stoneleigh Park,
Kenilworth, Warwickshire, CV8 2RW). Please keep a copy for your own records.
5