Name (Title)
*
Name
*
First Name
Last Name
Contact Telephone Number
Email
*
Name of School / College / Club / Beneficiary
School / College / Club Address
If the programme will take place at a different site, please specify.
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Preferred Method of Contact
Mintridge Programme Manager
First Name
Last Name
Mintridge Ambassador
Mintridge Programme Type
Gold
Silver
Bronze
Silver (Virtual)
Bronze (Virtual)
Silver (One on One Mentoring Only)
Programme Start Date
*
MM
DD
YYYY
For virtual programmes, what is your preferred online software?
e.g. Teams, Zoom, Fitswarm
For virtual programmes and safeguarding reasons, would you like to create the online link or would you like the Mintridge team to create it?
Are you happy with the schedule?
Please comment with any adjustments. Please note that we are allowing extra time in between sessions to clean down equipment / the area and allow for social distancing due to Covid - 19.
Do you provide hand sanitiser for their students and / or do the students provide their own hand sanitiser?
Is there anything in particular that you would like your Ambassador to focus on during the presentation?
e.g. Overcoming Failure
If presentations are not taking place, please leave this blank.
Where will the presentation(s) take place? Please provide as much information about the venue as possible (including size if possible).
If presentations are not taking place, please leave this blank.
Is the venue accessible?
Is the venue big enough for the Ambassador to deliver their presentation at a safe social distance?
Will there be a projector available?
Will there be access to YouTube during the presentation(s)?
Will students have access to a phone / tablet during the presentation(s) with WiFi or Data?
What is the dress code for the Ambassador?
This question is usually relevant for an awards / presentation evening, the Ambassador will usually be in their kit otherwise.
Is there anything in particular that you would like your Ambassador to focus on during the coaching sessions?
If coaching is not taking place, please leave this blank.
How many students are there in each session?
Will it be possible to have a list of the first names only of the students in each session?
This will allow us to create name stickers to help us to create rapport with the group(s). This will only take place if Covid - 19 restrictions allow.
If yes, please send them directly to your Programme Manager.
*NB We encourage small group learning.
What is the age group of the students involved in the sessions?
What is the ability of the students involved in the sessions?
Are there any students taking part that have illness, injury or any other special needs that we should be aware of?
Are there any religious or personal circumstances that need to be considered before your programme takes place?
For example; time allowances for religious prayer / shorter or less intense sessions for those taking part in fasting or religious practice / if there are certain topics or phrases that may be sensitive for those taking part.
Please let us know the quantity of equipment and/or stationery available?
Due to Covid – 19, will there be enough equipment for the students to have their own kit/equipment so that it does not need to be shared?
If possible, is the Mintridge team able to have a storage area for the Programme, to separate our kit and equipment from your equipment?
This is due to Covid - 19.
Where will the coaching sessions take place? Please provide as much information about the venue as possible (including size if possible).
Is the venue big enough for the Ambassador to deliver their physical activity session at a safe social distance?
Is the venue accessible?
If the coaching sessions are outside, is there an optional wet weather plan?
For example, an indoor hall that can be used.
How many school staff will be present during each session?
Are we able to publish photographs and videos on the Mintridge Website throughout the lead up and during the event?
*
Are we able to publish photographs and videos on Facebook throughout the lead up and during the event?
Are we able to publish photographs and videos on Instagram throughout the lead up and during the event?
Are we able to publish photographs and videos on Twitter throughout the lead up and during the event?
Are we able to publish photographs and videos on YouTube throughout the lead up and during the event?
Are we able to publish photographs and videos with the press throughout the lead up and during the event?
Are we able to publish photographs and videos with our funding partners and their website throughout the lead up and during the event (if applicable)?
Are we able to publish photographs and videos with our funding partners and their social media throughout the lead up and during the event (if applicable)?
If yes, are there any particular guidelines that you would like us to follow?
e.g. Photos but no names or website but not social media.
Are you happy for us to tag you in posts?
Are there any students that are unable to have their photographs taken?
If yes, please liaise with the Programme Manager.
Will there be access to Wi-Fi throughout the day?
Will there be parking available on the school site?
If no, is there parking nearby and can we book this in advance?
Is catering available for the Mintridge Ambassador & Staff?
Would you like the Mintridge team to collect "Old Balls" on the day?
NB - THIS IS UNAVAILABLE UNTIL JANUARY 2021 DUE TO COVID - 19.
Mintridge are working in partnership with Old Balls - A Social Enterprise who recycle, or upcycle, broken, unwanted or “Old Balls” and make them new again. Recycle - If the sports balls can be inflated and reused, they are given out to charities, sports clubs and individuals who need them. Renew - If the balls cannot be recycled or reused. The balls are renewed to produce a range of bespoke products, and sold, 50% of all profit is then used to purchase new balls for under-served children, clubs and communities.
Have you signed and returned the iAm Compliant Covid - 19 Specifc Risk Assessment?
This might have appeared in your Junk / Spam folder.
Do you have Covid - 19 guidelines that our Mintridge staff are able to read prior to the programme?
Please may you advise (if it isn't included as to whether there are regulations around food consumption?
Please can you confirm that you consent to The Mintridge Foundation storing this information and future information received for this programme on our private database. The information will be stored in a secure location and will not be published publicly.
We'd love to keep you up to date with THE MINTRIDGE FOUNDATION's projects and fundraising activities by email. If you would like us to send these emails to you, please opt-in below. THE MINTRIDGE FOUNDATION will never share your data and you can easily unsubscribe at any time.
BREACH OF TRUST: The beneficiary cannot speak directly to an ambassador regarding future programmes should this remove the Mintridge Foundation from the organisation.
As part of our programme, we may have prizes and equipment for students. Is this still possible to take place within your Covid – 19 Guidelines?
