Belmont Intermediate School - Cycling & Scooter Agreement
Belmont Intermediate School recognises the many positive benefits of students cycling and scootering to and from school and we encourage our students to do so. The benefits include improved health through physical activity, establishing positive active travel habits, promoting independence and improving safety awareness, reducing congestion, noise and pollution in the community.

The safety and well-being of our students is paramount and as such we require all students and the parents/caregivers of students who wish to cycle or scooter to read and adhere to the school's cycling and scootering policies as detailed below. Both students and parents are required to digitally sign their acceptance of the agreement.

Belmont Intermediate School is not responsible for bicycles/scooters brought onto or left on the school premises and is therefore not liable for students' bicycles/scooters being stolen or damaged by a third party. The school will notify parents/caregivers if children do not adhere to the below policies and permission to ride will be withdrawn until the issues identified have been satisfactorily addressed.

First name *
Your answer
Surname *
Your answer
Room Number *
Parent's Responsibilities
I understand and accept that it is my responsibility as a parent/caregiver to:
1) Ensure that my child has an appropriate knowledge of road safety.
2) Decide whether my child is competent to cycle/scooter independently to and from school safely. This decision rests with me as the parent or caregiver and the school has no liability for any consequences of this decision.
3) Take responsibility for checking that my child’s bicycle/scooter is roadworthy and regularly maintained.
4) Provide a lock to secure my child's bike/scooter.
5) Ensure a helmet which is in good condition, not cracked or damaged and fits securely and a high visibility vest is provided for my child.
6)Take out appropriate insurance cover as the school’s insurance does not cover loss or damage to bicycles/scooters.
Digital Signature - Parent first name and surname *
Your answer
Date *
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Student's Responsibilities
I understand and accept that it is my responsibility to:
1) Ride sensibly and safely.
2) Ensure that my bicycle/scooter is locked securely in the bicycle/scooter bays at all times.
3) Behave in an appropriate manner and consider the needs of others when cycling/scootering.
4) Wear a safety helmet and high visibility vest.
5) Dismount from my bicycle/scooter when entering the school gates or grounds.
Digital Signature - Student first name and surname *
Your answer
Date *
MM
/
DD
/
YYYY
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