Rider Information and Consent Form

Riders Name

First

Last

Riders date of birth

Phone Number (Mobile)

Email address

Gender

Address

Previous bike experience tick any that apply

Summary of riding experience:

Coaching /Guiding

Bikes

If using your own bike: make / model / age

Emergency contact details

First

Last

Relationship to rider

Telephone

Medical: Have you ever suffered from any of the following:

Tick all that apply

If yes, please give relevant details:

Medical conditions /allerges

If yes, please give details:

Consent for Photo/video taken during your session to be used on Mtbguides social media:

I accept that there is an inherent risk in participation in cycling activities:

Parent/Guardian Name (for under 18)

First

Last

Parent/Guardian Email

Parent/Guardian Phone

Permission & Agreement