Together Fund (Mums & Daughters) Sign Up Form - fully funded session

Hello Mums!

We are looking forward to the Mums and Daughters cycle training sessions in June & July 2023

Sessions: Wednesday from 6pm to 8pm.

To register, each mum must fill the form below for herself and her daughter.

This session is fully funded therefore our funders require demographic information (this will be stored separately to your above information).

The demographic information is shared with our funders as statistics (no names or personal details are ever shared).

Together Fund - Mum & Daughters

Name of the booker(Required)

Address, including Postcode - Must be RBKC(Required)

Contact number of the booker(Required)

Email address of the booker(Required)

Emergency contact (name & number)(Required)

Rider 1 (Mum)

Full name Rider 1(Required)

Cycling ability - Rider 1(Required)

Age Category - Rider 1(Required)

Gender identity - Rider 1(Required)

Ethnicity - Rider 1(Required)

Does Rider 1 needs to borrow a cycle?(Required)

Length of inner leg (in cm) - Rider 1

Rider 2 (Daughter)

Full name Rider 2(Required)

Cycling ability - Rider 2(Required)

Age Category - Rider 2(Required)

Under 16? Please indicate age(Required)

Gender identity - Rider 2(Required)

Ethnicity - Rider 2(Required)

Does Rider 2 needs to borrow a cycle?(Required)

Length of inner leg (in cm) - Rider 2

Final information

Does any of the riders have any disability or medical issues that we should be aware of? (write none if not)(Required)

How did you hear of this course?(Required)

Please tick one of the boxes below indicating whether your child will wear a cycle helmet on the cycle training course(Required)

My child will wear a cycle helmet that is safe and suitable for use. I understand that Bikeworks will not be held liable for any injury which is caused by the wearing of a helmet.

My child will not be wearing a cycle helmet on this training course and I understand that Bikeworks will not be held liable for the result of any injury, which may have been prevented by the wearing of a helmet.

Photography & Film(Required)

Yes - I give Bikeworks permission to use photographs or film as below

No - I do not give Bikeworks permission to use photographs or film as below

Bikeworks CIC request the right to use photograph(s) or film taken of the participant during any Family Cycling activity (including Special Olympics training and competitions) run by them and any reproductions or adaptations of the photograph(s) or film for all general purposes in relation to Bikeworks’ work including the right to use them in any publicity materials, web content, books, newspapers and magazine articles whenever Bikeworks chooses to do so in line with their fundraising and publicity purposes.

Marketing Updates:(Required)

Yes (You can contact us at any time to opt out of receiving direct marketing information by emailing enquiries@bikeworks.org.uk)

Sometimes Bikeworks likes to get in touch with previous riders to let them know about additional cycling news and opportunities. Do you consent to receiving email contact from us? Please tick one of the options.

Please review Terms & Conditions here

I read and accept the terms and conditions:(Required)

I accept that Bikeworks’ instructors may at any time refuse to continue to involve my child in the session if either his/her behaviour during the session or ability level is felt by them to be unsuitable. By signing this agreement I confirm that Bikeworks is not responsible for any injury my child may incur before, during or after the sessions nor for any loss or damage to any property caused before, during or after the sessions other than where such injury or damage is caused by a Bikeworks’ instructor’s negligence. I undertake to make the instructor aware of any medical condition my child has which may adversely affect my ability to take part in the session. I accept that the consent I am providing by signing this form relates to all supported cycling activity sessions my child takes part in with Bikeworks on or after the date this form is signed.

Bikes and helmets are provided!

For more information on Cycle Training click here