JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Potters Bar Cycling Club Membership (3 month trial)
Please fill in all questions to apply to PB Cycling Group
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name
*
Your answer
Email
*
Your answer
Mobile phone number
*
Your answer
Address
*
Please include your postcode
Your answer
Are you able to cycle 50km confidently?
*
We recommend a road bike, or hybrid with thin tyres - it is hard work riding on the road with a mountain bike!
Yes
No
What is the longest ride you have completed so far?
30-40km
40-50km
50-60km
60km +
Clear selection
Emergency contact details (including phone number)
*
Please enter the details of someone who we would contact if you were to fall ill or have an accident while out cycling
Your answer
Is there anything you think that we need to know about you?
Your answer
Please agree to our constitution
https://bit.ly/3vzgNNv
*
I agree
Do you agree to paying the £5 cost for a three month trial?
*
I agree
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report