1:3 Sessions for Non Riders - Brookfield Community School, Southampton - Tues 5th or 12th Aug 2025

Full name of child attending

DOB of child attending

Gender of child Male Female Prefer not to say Prefer to self-describe as

If gender answer above is self-describe please state here

Current year group at school

Current School Attending

Details of any medical needs or additional support to learning

Medical information - medication will need to be given to instructors on the day

First emergency contact name, number and relationship

Second emergency contact name, number and relationship

My child needs to borrow a bike Yes No

My child needs to borrow a helmet Yes No

Read the product details below? If No is selected you will be contacted by a learning coordinator to ensure that you are prepared for the training No Yes

Will your child be collected or make their own way home? Collected Make their own way home