Coach Registration/Renewal Form

Fill in your details below to register as an RDA coach or renew your membership. You will be charged a fee of $20.00AUD.

You can also download the printable form here and post your form with payment to RDA Australia – PO Box 310, Torrensville, SA, 5031.

Your details

:
Date of birth:
Do you identify as having a disability?

Senior First Aid Certificate Date:
WWCC Certificate Number:
WWCC Issue Date:
Are you paid for coaching at RDA?

Your Current Coaching Qualifications

Level(s) of qualification:
Approx. coaching hours per year:
RDA Centre(s) coaching took place:

Workshops attended in 2018




Other RDAA Approved Activities (refer to the NCAS RDAA Updating Policy)




Other information

I am continuing as a Member of an affiliated RDA Centre in 2019 and have met my compulsory coaching activity for 2018 and wish to be re-registered as an RDAA Coach for 2019
Authorised Reference:
Name:
Position:
Contact phone or email:
I wish to take leave from coaching in 2019 and will not be able to meet the minimum coaching requirements. I understand that if I do not complete the compulsory activities within two years that I need to update my coaching qualification as per the NCAS Updating Policy.
I wish to cease coaching with RDA until further notice.

Payment Details