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
Thank You!
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