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Booking FormLiam Connerney2021-05-27T15:28:38+00:00

Booking Form

Rider Details

Name(Required)
Gender(Required)
DOB(Required)
Please enter a number from 14 to 99.
Address(Required)
Email(Required)

Emergency Contact Details

Name(Required)

Medical and Specific Needs

It is your responsibility (or that of a parent/guardian/carer if under the age of 18) to provide the coach with details of any medical or health conditions, allergies, or dietary or other specific needs that might affect your ability to participate in cycling. Please note that a coach is unable to provide guidance or make decisions relating to medical or health conditions. Rather, if you have any concerns about participating in any form of physical activity, please consult with your GP before signing the consent form.

Arrival and Departure Arrangements if under 18

Rider Information

I have read and understood the information on this form and the coach has satisfactorily answered any questions I have asked. I understand and agree that I participate in coached sessions and/or training prescription entirely at my own risk. I have considered the nature of such sessions; I will participate in a safe manner and follow all reasonable instructions from the coach. I confirm that the information I have provided is correct and complete to the best of my knowledge(Required)
I have read and understood the information on this form and the coach has satisfactorily answered any questions I have asked. I understand and agree that I participate in coached sessions and/or training prescription entirely at my own risk. I have considered the nature of such sessions; I will participate in a safe manner and follow all reasonable instructions from the coach. I confirm that the information I have provided is correct and complete to the best of my knowledge
Parental/Guardian/Carer Consent for Riders Under the Age of 18
(Required)
(Required)
Name(Required)

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