Bikeability Registration

Bikeability Registration Form

* Indicates required field

Parent/Carer Name *

First

Last

Phone Number *

First Child Name (£15.00) *

First

Last

Second Sibling (£15.00) *

First

Last

Third Sibling (£15.00) *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

School Year *

Dates *

Monday 9th April Tuesday 10th April

Parent/Carer Contact Email Address *

Please tell us if your child has any major medical problems that you feel we should know about. Please also tell us if you require the extended activity service for an extra £3 per day.

Comment *

Submit