2024-2025

Please note that this form is best completed on a Computer, and may take 10-15min to complete. Please ensure you have details including your Working with Children Check and required Sport Integrity Australia Certificate of Learning available prior to submission.

Program Role

Sport Program*

Please Select the Sport Program you will be involved in

Coach or Support Staff Role*

Please select the coach or support staff role you are accepting


Contact Information

Select or enter value
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Best email address for contact

Contact Hours

Whilst Email is the primary method of communication, from time to time the Academy may need to contact you by phone. We understand that our coach and support staff have other commitments, as such, please advise the most appropriate time should we need to contact you.

Do you identify as any of the following Indigenous or Culturally Diverse groups?
Local Government Area

Please select the Local Government Area you reside in, or closest LGA for your Civic Reception attendance if out of area


Sport Qualifications and Representative Information

Academy Coach and Support Staff Status

Please identify previous roles held within the Academy if returning following a break in service.

Are you a former South West Sydney Academy of Sport Athlete?

Please select any of the following that you are currently involved with, or will be during the upcoming program year.

Please include details of year first obtained accreditation, and any subsequent updates or plans to update accreditation?

Please upload a copy of any current certificates at the end of this agreement

Do you have any professional qualifications or experience, whether degree, employment or education in the following subject areas?


Transport, Accommodation and Meals

Current Driver Licence
Shared Accommodation Consent

Please list any dietary requirements or food allergies


Emergency Contact / Next of Kin

Medical Information

Do you have Private Health Cover?
Are you covered for Ambulance through a private Health Insurance Fund

Have you been vaccinated / immunised for the following? Please select all that apply

Please provide the details of any regular medication taken


Child Protection and Safeguarding, Media and Code of Conduct Consent

Policy Statement


The South West Sydney Academy of Sport is firmly committed to providing a safe environment for children and young people in our care and aims to recognise and notify suspected child abuse and neglect, in accordance with the NSW Government principles for child protection and intervention.  To achieve this, the Academy promotes the principles and responsibilities of child protection among all paid, voluntary, permanent or casual staff, administrators and coaches formally involved in the Academy activities.


Screening of Staff


All Academy staff, or supervising persons (whether voluntary or paid) in a child-related position understand that legislation exists where several checking processes will be undertaken to ascertain their suitability. Every person engaged by SWSAS whether in a voluntary or paid role will need to have an Office of the Children's Guardian www.ocg.nsw.gov.au verified Working With Children Check (WWCC).


If a staff member is identified as a "registerable person" under the Child Protection (Offenders Registration) Act 2000, then they are prohibited from employment in any child-related position in the Academy.  All staff complete a prohibited employment declaration and an employment screening consent form accordingly.


Further information on the Academy's Child Protection and Safeguarding Policies are available here: 


https://www.swsas.org.au/child-protection.html


If concerns were to arise, you are to contact the Academy immediately and appropriate investigations and actions will be taken.

Child Protection / Sport Integrity Training

Please note all coach and support staff are required to have completed the following courses available on the Sport Integrity Australia e-learning hub, and provide a copy of their Certificate of Learning prior to commencement within the program.


Access to course content is free via Sport Integrity Australia.


  • Anti-Doping Fundamentals Course
  • Safeguarding Children and Young People in Sport Induction
  • Introduction to Illicit Drugs in Sport
  • PBTR - Inclusive Coaching
  • Competition Manipulation and Sports Betting
  • Clean Sport 101
  • Coaches Course (Anti Doping Module)
Child Protection Consent*
Media and Privacy Notice


Media Consent

I agree to allow the South West Sydney Academy of Sport (SWSAS) to use my name and the photographs and/or video footage taken of myself at any SWSAS sessions or events in the promotion of the Academy's services and initiatives to the media and to the general public. SWSAS may also take video footage of myself for the purposes of sport specific video analysis. This video footage may also be used for the promotion of SWSAS. 


Furthermore, photographic and video footage may be taken by contracted professional photographers at events such as the Regional Academy Games. You understand that this footage may be used to promote the Regional Academy Games, the Regional Academies of Sport incorporated, and SWSAS.



Privacy Notice

The Academy's policy on collection use and storage of personal information complies with Australia's Ten National Privacy Principles as defined in the Privacy Amendment (Private Sector) Act 2000. Details of our full privacy policy explaining how the Academy complies with the National Privacy Principles can be obtained from the Academy website https://www.swsas.org.au/policies.html


In summary:


For the Academy to fulfil its obligations to Stakeholders, we need to be given permission to release your child's name, address and scholarship sport to the relevant regional and state sporting association and to the relevant local government council.

The South West Sydney Academy of Sport collects various information to enable processing and assessment of your child's athlete agreements. Some of the information collected will be provided to State Sports Organisations, media outlets, Local Councils and other Stakeholders. In particular, your child's first and last name, suburb where they live and what Academy sport they are involved with. Images and information may also be included in newsletters, web site and other promotional material for the Academy.


You are not obliged to provide the information but if the information is not provided the Academy will be unable to process your application. Any information provided by you to the Academy can be accessed by you during standard office hours and updated by writing to the Academy or calling on (02) 4627 7622. All information provided on this form and gathered throughout the assessment process will be stored on a database that will only be accessed by authorised Academy personnel and is subject to privacy restrictions.


Should you have any concerns, please contact the Academy Chief Executive Director immediately by telephone (02) 4627 7622


Code of Conduct and Agreement

Coach and Support Staff Code of Conduct
  • Place the safety and welfare of the participants above all else.


  • Be aware of and support the Academy’s injury management plans and return to play guidelines.


  • Help each person (athlete, official, etc) to reach their potential. Respect the talent, developmental stage and goals of each person and encourage them with positive and constructive feedback.


  • Encourage and support opportunities for people to learn appropriate behaviours and skills.


  • Support opportunities for participation in all aspects of the sport.


  • Treat each participant as an individual.


  • Obtain appropriate qualifications and keep up-to-date with the latest coaching practices and the principles of growth and development of participants.


  • Act within the rules and spirit of your sport.


  • Promote fair play over winning at any cost.


  • Respect the decisions of officials, coaches and administrators.


  • Show respect and courtesy to all involved with the sport.


  • Display responsible behaviour in relation to alcohol and other drugs.


  • Act with integrity and objectivity, and accept responsibility for your decisions and actions.


  • Ensure your decisions and actions contribute to a harassment-free environment.


  • Wherever practical, avoid unaccompanied and unobserved one-on-one activity (when in a supervisory capacity or where a power imbalance exists) with people under the age of 18.


  • Ensure that any physical contact with another person is appropriate to the situation and necessary for the person's skill development.


  • Be honest and do not allow your qualifications or coaching experience to be misrepresented.


  • Never advocate or condone the use of illicit drugs or other banned performance enhancing substances or methods.


  • Never participate in or advocate practices that involve match fixing


  • Respect the rights and worth of every person, regardless of their age, race, gender, ability, cultural background, sexuality or religion.


  • Do not tolerate abusive, bullying or threatening behaviour.
Coach and Support Staff Agreement*

By submitting this document, I agree that all information provided is true and correct to the best of my knowledge. And agree to adhere to all policies and reasonable direction from the Academy.


I agree and understand that the position I am entering into is Voluntary in nature, and there is no expectation nor requirement of any remuneration, nor the relationship of employee and employer.


I agree and understand that the Academy may terminate my position within the program at any time, and without the need for a detailed reason.

Upload the requested files, including any

  • Sport Integrity Australia Certificate of Learning
  • First Aid or Sport Trainer Certificates
  • Any Additional or supporting documentation
Drag and drop files here or