Bikeability Booking Form

Type
Form
Confirmation

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Bikeability Individual Booking Form (aged 16 or over)

Do you consider yourself to be in good health and able to take part in this activity? *

Yes

What Bikeability course level did you want to book? *

Adult Confidence

Adult Fix

Adult Learn2ride

Inclusive 1 - 1

Mountain Bike Group Ride - Friston

Whizzability Family Fun

There are currently no courses available for the chosen course level.

Contact name *

Enter the first and last name. You can optionally add any middle names too.

Address *

If you have a postcode type it in the text box below and use the 'Find Address' button to complete your address details.

Flat number or firm

Building name or number

Street name

Village or part of town

Town

County

Postcode

Please select the correct address:

Phone *

This is the contact telephone number including area code.

Confirm phone *

Email *

Confirm email *

Gender *

Male

Female

Other

Prefer not to say

Ethnic group *

Asian or Asian British

Black, African, Caribbean or Black British

Mixed or Multiple ethnic backgrounds

White or White British

Other ethnic group

Prefer not to say

How did you hear about this course?

Also, please add any further relevant information, e.g. medical, that we should be made aware of. Please note, there is a maximum limit of 300 characters.

Please contact East Sussex County council to discuss other workshop dates on 07584262556 or 07881282725 or email holidaycourses@eastsussex.gov.uk.

DISCLAIMER: *

I understand that East Sussex County Council cannot accept liability for any injury suffered or any damage to personal belongings, including bicycles.

Privacy Notice: *

I can confirm that I have read and understood the Privacy Notice and I am happy for my personal data to be processed in line with this statement.

Once you submit this form, your application will be assessed and you will be sent an email to arrange payment. A confirmed booking will not be made until payment has been received.