Supporter Registration Form 

Please complete the form below if you would like to attend one of our cycling sessions as a supporter/carer for a cyclist. Please note that supporters must have an age of 18 years or more.

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

  • Who are you supporting?

    Please give cyclist's full name and your relationship to the cyclist.
  • Please provide name & address of centre/organisation/school etc. arranging your attendance: (Group must be registered with Wheels for Wellbeing)
  • Supporter information

  • Emergency Contact

  • (must be signed before your Cyclist(s) can cycle with us)
    I have read and agreed to Wheels for Wellbeing’s Ground Rules And Guidelines for Carers and Support Workers I confirm that I have a consent of my emergency contact to share his/hers personal details.