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2025 Dis-Chem Ride 4 Sight - TANDEM QUESTIONAIRE
Be Bold, Be Brave and step up to the plate. 16 February @ Boksburg Stadium
Lead the pack as a
PILOT
or
STOKE
the engine room from behind and make the dreams of a sight impaired cyclist come true.
* Indicates required question
What is your current level of fitness?
Beginner (Exercise occasionally, light activity)
Intermediate (Exercise regularly, moderate activity)
Advanced (High level of fitness, intense activity)
Have you participated in the Dis-Chem Ride 4 Sight on a tandem before?
Yes
No
First Name
*
Your answer
Last Name
*
Your answer
Email
*
Your answer
Phone number
*
Your answer
Area of Residence
*
Your answer
Do you own a tandem bicycle ?
Yes
No
I have access to one
Clear selection
Would you be willing to pilot a tandem for a person with a disability ?
*
Yes
No
Maybe
Do you have any experience cycling on a tandem ?
Yes, as a pilot
Yes, as a stoker
No, but willing to give it a test ride
Contact details of a person / people with a disability who
might be intersted in participating at our event ?
Your answer
Would you be interested in assisting visually impaired individuals in any of the following sporting disciplines? (Select all that apply):
Golf
Lawn Bowls
Running
Triathlon
Guiding a child in a buggy(on a single bicycle)
Assist with transport to events
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