Chippawa Lions Club Bike Rodeo Registration
Please complete the following form to register your child for the Chippawa Lions Club Bike Rodeo.
If you have any questions or concerns, call Victoria La Fratta (Heart Niagara's Cycling Safety Education Project Manager) at 905-358-5552 Ext. 108.
Child's First & Last Name *
Your answer
Parent's First & Last Name *
Your answer
Address *
Your answer
Phone Number *
Your answer
Email *
Your answer
Does your child have a bicycle? *
Does your child have a bicycle helmet? *
Does your child have a bike bell? *
Does your child have bike lights? *
Approximately how often does your child ride their bike? *
Approximately how long has your child been riding a bike? *
*
Thank you for registering your child to participate in the Chippawa Lions Club Bike Rodeo. We look forward to teaching your childe safe cycling skills!
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