One-to-one cycle training request form

You can find training charges on One-to-one cycle training. If you need help to apply, please phone 033 022 26260.

Once we have received your form, we will pass your details to one of our nationally accredited instructors. The instructor will contact you directly to arrange your training.

We will send you details of your booking and how to pay before the session.

To protect clients and instructors, trainees under 18 years of age and vulnerable adults requiring 1:1 training will need to attend with a parent or another suitable adult, unless consent is given by ticking the appropriate box on the consent form.

We want to make sure you have had an enjoyable experience so we will ask you for feedback after your course.

This form will take approximately 5 minutes to complete.

Your data privacy

Before completing this form please read our general Privacy Policy (opens in a new window).

This explains why we ask for your data, what we do with it and how long we will keep it. It also explains how you can find out what data we hold about you and how you can ask us to delete it.

Trainee details

Title

Select or enter title.

Other

Enter your title if it is not listed above.

Trainee's first name *

Enter trainee's first name.

Trainee's last name *

Enter trainee's last name.

Parent/guardian first name

Enter the first name of the parent/guardian if the trainee is under 16 years of age.

Parent/guardian last name

Enter the last name of the parent/guardian if the trainee is under 16 years of age.

House name or number *

Enter the address name or number. This could a flat, house or building name or number.

Address line 1 *

Enter the first line of the address. This could be the street name.

Address line 2

Enter the second line of the address if you need to. This could be the village name.

Town or city

Enter the town or city of the postal address.

County

Enter the county.

Postcode *

Enter the postcode, with or without spaces.

Email address *

Enter an email address where we can write to you.

Phone number *

Enter a daytime phone number that we can ring you on. This can be a mobile or landline number.

Is the trainee male or female? * Select your answer using the buttons. Male Female

Age range *

Select trainee's age range from the list.

Trainee's age *

Enter the age of the trainee who is under 16.

Which type of instructor would the trainee prefer? *

Select your answer from the list.

How would you rate the trainee's cycling ability?

Select your answer from the list. 1 being 'complete beginner' and 10 being 'advanced'

What do you/the trainee hope to get out of the session? *

Enter details below.

Does the trainee have any health concerns we should know about? If you are in any doubt, please consult your doctor before undertaking the training. *

Enter details below.

Comments

Add any comments or specific requests.

Submitting your form

Click the submit button only once.

Please be patient as it will take a few moments to process your form and redirect you to our confirmation page.

Complete the online booking form for one-to-one cycle training.

Your data privacy

Trainee details

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