Cyclist Registration Form 

Please complete the form below if you would like to attend one of our cycling sessions.

If you prefer you download the form here and please make sure you read our ground rules before you complete the form.

  • Cyclist information

  • Or name & address of centre / organisation arranging your attendance:(Centre must be registered with Wheels for Wellbeing)

  • Current level of activity in a typical week. This is physical activity which makes you feel warmer and raises your heart rate.
  • Emergency Contact

  • Declaration


    Must be signed before cycling with us
    • I understand that the sessions will be led by experienced and qualified cycle trainers
    • I am aware that they will offer me guidance, advice and support with regard to cycling and cycling related matters and I agree to cycle under their supervision
    • I have read and agreed to Wheels for Wellbeing’s Ground Rules and so have all the people who accompany me
    • I accept that there may be an element of risk in all activities, but am satisfied to proceed with the session
  • Monitoring data


    This data is crucial in assisting us to obtain funding so we can keep providing Cycling for All! This information is confidential and helps us ensure we are providing the service without discrimination.
  • Answer the below only if cyclist is over 18 years of age