This form should be completed by all riders (or parent/guardian of any riders under 18) participating in coached sessions from a British Cycling qualified coach.
You should read the appendix carefully before providing consent.
1 - Riders Details
2 - Emergency Contact Details
3 - Medical & 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.
Please give details of any medical or health conditions, allergies or dietary or specific needs that might affect your participation in cycling and what support/modifications are needed by the coach.
Please list any medications you take on a regular basis. (This information may be required by the emergency service in the event of an accident).
4 - Arrival & Departure Arrangements
While riders under the age of 18 may travel to and from sessions unsupervosied or may not be accompanied by a responsible person who is not the rider's parent/guardian/carer, the coach has responsibility to ensure that all riders leave the session safely.
If under the age of 18, please give details of typical arrival and departure arrangements, e.g. the names of people you authorise to accompany the rider, and/or whether the rider is allowed to depart alone or with friends.
5 - Rider Information
Previous cycling experience - Please detail the riders experience (more info the better) eg 1. Raced 2 years in expert. Confident with jumping or eg2. Raced for 2 years in expert. Scared of jumping/manuals.
6 - Consent for Riders Age 18 & Over
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 my child participates in coached session and/or training prescription entirely at their own risk. I confirm that the information I have provided is correct and complete to the best of my knowledge.
Appendix
A1 - Data Protection
The information provided on this form will be used for the purposes of providing you/your child with coaching services throughout the year. This information will be stored, processed and destroyed in accordance with the principles of the Data Protection Act 1998.
A2 - Bike, Helmet and Clothing
It is the responsibility of the rider (or their parent/guardian/carer if aged under 18) to ensure that their bike, helmet and clothing is appropriate, well maintained and in a safe condition prior to participating in every session. Riders must wear a helmet which complies with current safety regulations when riding their bike.
