VC Jubilee New Rider Inquiry – Brighton Excelsior CC

This form is to be completed by the parent or guardian of the rider who wishes to take part in club activities. Once we receive this we will invite your child (and you) to try our first sessions.

Riders Details – Step 1 of 2

Rider Name *

First

Last

Date of Birth *

Riders Medical, disability and any other information: *

Please detail any important information that our coaches/club should be aware of (eg epilepsy, asthma, diabetes, allergies, adhd, hearing or visual impairment, physical or learning disability, etc) or any other relevant information such as any specific requirements regarding the rider leaving the sessions. Please include any medication and indicate if the rider should be carrying this. Also if the cyclist has a medical condition, the recommended treatment/actions to be taken if symptoms appear…

Parent & Guardian 1 Details

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