Velocity Social Cycle Contact Information
Email address *
First name *
Last name *
Date of Birth *
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Mobile number *
Home phone number *
Address and postcode *
Name of person to contact in case of emergency (and relationship to you) *
Your emergency person's phone number *
Please read the following in order to give your informed consent to participate in Velocity's Social Cycle Rides.
I agree that I have read and understood the above terms. I understand that risks are involved and accept that Velocity is not liable for injuries or damage that occur. I agree to consult my GP if I have any doubt about my fitness to participate in the project activities and to inform project staff about any health/fitness concerns. *
Please give details of any medical information, injuries, allergies or medicine you take regularly or carry with you which it would be useful for us to know about *
Do you have any other additional needs you'd like us to know about?
Which ride(s) are you interested in?
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