MSSC Cycle to School Contract
This form serves as a means for us to obtain your electronic consent regarding your child's permission to cycle to school. By completing and submitting this form, you are granting your child the authorisation to cycle to school safely and responsibly.

If the provided email and mobile number match the records we hold, we will send you a confirmation SMS. If you do not get a confirmation SMS, the school will be notified and you will receive a phone call or email to confirm your identity.

Thank you for your cooperation and support in promoting a healthy and eco-friendly mode of transportation for our students.

You will receive a copy of your answers to the email address you supply below.

Please note: This form needs to be completed for each individual student. Please do not supply multiple names.
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Email *
I'm applying for my child's... *
Please select if this is a first time application or you'd simply like a replacement.  The initial bike permit is free, replacement cards are chargeable.
Your Full Name *
The person completing this form must have registered parental responsibility.
Your Mobile Number *
Please provide your mobile number (no spaces) for verification purposes, as we will send a confirmation SMS message to ensure the validity of your consent.
Student Forename *
Student Surname *
Year *
Form *
Bicycle Make/Model *
Bicycle Colour *
I wish to apply for a cycle to school permit and agree to adhere to the rules set out below.
For permission to cycle to school to be granted, parents and students must read, agree and sign below to adhere to the following rules of safety:
  1. No student is allowed to bring a bicycle on to the school site unless they and their parent/carer has approved this agreement.
  2. All bicycles must be roadworthy and appropriate for the age of the student in terms of frame size and seat height. All bikes must have brakes that work safely.
  3. Students must wear a helmet to cycle to and from school and this helmet must be visible to school staff when students enter the school site.
  4. When students are on school site they must dismount their bike and walk the bike to the cycle storage areas.
  5. During the winter months when cycling to and from school in the dark, parents will ensure that students wear reflective clothing and that all bikes have front and rear lights.
  6. All students will cycle in a safe manner and take into account pedestrians and other school children, as outlined above. Any students riding dangerously, on public roads, on public footpaths, or being disrespectful to others on the way to school, or when leaving school, will also have their bike privileges withdrawn. Bikes may be locked in school for parent/carer collection.
  7. All students will refrain from listening to music through earphones whilst cycling to school.
  8. All students will undertake training sessions led by local PCSOs if deemed appropriate.
  9. Students should not, under any circumstances, tamper in any way with another student’s bicycle, lock or helmet. A student found to have done this, particularly in a way that might endanger the user’s safety, will be expected to pay for any damage caused, will have cycle privileges withdrawn and further sanctions may be applied. For serious offences, the police may be involved.
Please note that cycling, or not being able to cycle to school, should bike privileges be withdrawn, cannot be used by a student as an excuse for late arrival. Parents/Carers should ensure that students are on time for school, and if their bicycle privileges have been withdrawn, they have an alternative method of getting to school.  Parents/Carers must also ensure that if a student has an after-school detention, other transport arrangements are made should the parent feel this is necessary.

Permits don't need annual renewal and are valid as long as the student is enrolled. Students must be able to produce a valid permit in order to store their cycle in the correct bike shed on the school grounds.
The student that will be cycling to school must read and understand the following rules before permission will be granted.
When cycling to school, I will:
  • WEAR a CYCLE HELMET
  • Give way to pedestrians, leaving them plenty of room
  • Keep to my side of any white dividing line
  • Cycle in single file
  • Be prepared to slow down or stop when necessary
  • Not cycle at high speeds
  • Be careful at junctions, bends and entrances
  • Remember that many people are hard of hearing or visually impaired, and may not see or hear you
  • Consider carrying a bell, and use it to avoid surprise
I have read and understood the conditions outlined above and agree to adhere to them in order to be given permission to cycle to school and store my bike in the allocated cycle shed.
Parent/Carer *
Tick the boxes below to give consent for your child to cycle to school...

Required
A copy of your responses will be emailed to the address you provided.
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