Lake Farm Primary Parents Bikeability Invitation Form
If you would like to give your child the opportunity to attend this bikeability course please complete the form below. All information is confidential and secure.
Applicants will be registered on a first come first serve basis, with 40 spaces available.
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Child's First Name *
Child's Surname *
Gender *
Year group *
Ethnicity *
Eligibility for pupil premium
Clear selection
Does your child have any diagnosed Special Educational Needs/Disabilities (SEND)?
Clear selection
Health or Behavioural (Concerns (if none apply please enter N/A) *
Please ensure you enter any information you think our instructors may need to know, remember Level 2 will be out of the school grounds so we need to know as much as possible. eg. Asthma/ADHD/Dispraxia etc
Parent/Carer Full Name *
Relationship to child *
Emergency contact tel. no. *
Helmet Consent *
My child will provide and wear a helmet throughout the duration of the course. (please note this is a requirement to take part on the course unless there is a religious reason  eg. wearing of a turban or medical reason why they cannot)
Sharing of data *
Please tick the below box to confirm you are happy for your details to be shared with your child's school and Hillingdon's Cycle Instructor Team in order for registers to be made. Please note by not ticking this box we will be unable to process your form
Required
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