Bikeability Booking Form

Bikeability Individual Booking Form (aged under 16)

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

Yes

What Bikeability course level did you want to book? *

Level 1Plus

Mountain Bike Group Ride - Friston

Whizzability Family Fun

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

Child's name *

Child's date of birth *

For example, 12 11 2007

Day

Month

Year

Parent's/Guardian's 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 *

What school is your child attending?

I agree for my child to have photos taken for media promotion of the event *

Yes

Does your child have a SEND statement? *

Yes

Prefer not to say

Does your child receive free school meals? *

Yes

Prefer not to say

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: *

Having had an opportunity to view the Privacy Notice in relation to this service, I can confirm that I am happy for mine and my child’s personal data to be processed in line with terms set out in the Privacy Notice. Where my child is over 13 years old (and has the capacity to understand), I have explained to them the terms which are set out in the Privacy Notice and can confirm that they also consent to their personal data being processed under those terms.

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.

There were error(s) in your submission.

Bikeability Individual Booking Form (aged under 16)