The Cycling Co. Rider Information Form
Please provide as much detail as possible so we can serve you better.
Email address *
Participant First & Last Name *
Your answer
Participant's age? *
Your answer
Parent/Guardian Name (applicable for participants under the age of 18)
Your answer
Phone Number *
Your answer
Emergency Contact (name & phone number) *
Your answer
Which program(s) are you interested in? Check all that apply. *
Required
Participant's Riding Level (MTB/Road) *
Tell us a bit about riding experience? Include number of years mountain biking and/or on the road. *
Your answer
What are your overall cycling goals? *
Your answer
What are your biggest strengths/weaknesses as a cyclist? *
Your answer
What is something you would like to become better at on the bike? *
Your answer
Have you received prior coaching/instruction? When? Where? Which coach/company? Did it help you improve? *
Your answer
Are you currently suffering from or recovering from any recent injuries? Explain. *
Your answer
Do you have any food or medical allergies? Explain.
Your answer
Is there anything else we should know?
Your answer
I would like to receive periodic email updates on upcoming programs and events. *
Payment Method
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