Register as a Coach

The Coach Database has been developed to:

Inform coach education providers of course need
Improve communication to coaches of local schemes and initiatives
Support organisations find coaches

Please complete the form to enter your details into the Sport Coach Database. If you have any queries please contact:Â Lane1 Sports Management & Coaching.

The information marked with an asterisk (*) must be filled in to complete the form.

Personal Details

Name*

Position*

Address*

Town*

County*

Post Code*

District

Home telephone

Mobile telephone*

Email*

Date of Birth

Gender*

Do you consider yourself disabled?

Are you registered disabled?

CRB Information

Please complete this section with details from your most recent CRB check

Do you have a current CRB (less than 3 years old?)*

What is your CRB number?

Date of CRB

Which organisation did you get your CRB done with?

Coaching Status

Please select all that apply

Paid Coaching

Full time

Part time

Hours per week available

Please indicate which age groups you currently coach or are interested in coaching

Currently coach

Early years (Under 5s)

Children (5-12 years)

Young People (13-19 years)

Would like to coach

Early years (Under 5s)

Children (5-12 years)

Young People (13-19 years)

Which organisation(s)/club(s) do you coach for?

Please provide information on the coaching experience you have:

Sport Specific Qualifications - Level 2 (Coach)

In this section you can list up to three Level 2 qualifications and dates they were gained.

Sport 1

Date qualified

Sport 2

Date qualified

Sport 3

Date qualified

Please list any other Level 2 Qualifications you have and the date gained:

Sport Specific Qualifications - Level 3 (Club Coach)

In this section you can list up to three Level 3 qualifications and dates they were gained.

Sport 1

Date qualified

Sport 2

Date qualified

Sport 3

Date qualified

Please list any other Level 3 Qualifications you have and the date gained:

Sport Specific Qualifications - Level 4

Sport 1

Date qualified

Sport 2

Date qualified

Sport Specific Qualifications - Level 5

Sport 1

Date qualified

Sport 2

Date qualified

Generic Qualifications

Please select the generic qualifications you have and the date gained. You can select a maximum of four.

Qualification 1

Date qualified

Qualification 2

Date qualified

Qualification 3

Date qualified

Qualification 4

Date qualified

Coach Development and Training

Please list below any courses or training you would like to attend.

This information will be used to inform Coach Education providers of training need. Please include both sport specific training, generic training plus any other training that will help you become a better coach

Data Protection

Thank you for completing this form. Please read through the following statements and tick the relevant box if you give your consent.

I consent to receiving emails from Lane 1 Coaching and partners which are relevant to coaches and coaching.

I consent for the information I have given to be shared with organisations that organise coach education and support coaches.

I consent to the information I have given to be shared with organisations that are looking to employ/deploy a coach with the qualifications I have.

I consent to becoming a Derbyshire â€œCoach Markâ€ registered coach and agree to undergo the training to gain this qualification.