Coaching Consent Form
This form should be completed by all riders participating in coached sessions or prescribed training from a British Cycling qualified coach. You should read the appendix carefully before providing consent.
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Email *
1. Rider Details
Full name *
Gender *
Date of birth *
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Address *
Phone number *
2. Emergency Contact Details
Full name *
Relationship to rider *
Phone number *
3. Medical and Specific Needs
It is your responsibility (or that of a parent/guardian/carer if under the age of 18) to provide JLBMX Coaching with details of any medical or health conditions, allergies, or dietary or other specific needs that might affect your ability to participate in cycling.  Please note that the coach is unable to provide guidance or make decisions relating to medical or health conditions. Rather, if you have any concerns about participating in any form of physical activity, please consult with your GP before signing the consent form.


Please give details of any medical or health conditions, allergies, or dietary or specific needs that might affect your participation in cycling and what support/modifications are needed by the coach.
Please list any medications you take on a regular basis.(This information may be required by the emergency services in the event of an accident).
4. Arrival and Departure Arrangements
While riders under the age of 18 may travel to and from sessions unsupervised or may be accompanied by a responsible person who is not the rider’s parent/guardian/carer, the coach has a responsibility to ensure that all riders leave the session safely.
If under the age of 18, please give details of typical arrival and departure arrangements, eg the names of people you authorise to accompany the rider, and/or whether the rider is allowed to depart alone or with friends.
5. Rider Information
Previous cycling experience. *
What do you want to achieve from the sessions? *
Please detail any other specific information that is relevant to participation in cycling activity sessions.
6. Consent for Riders Aged 18 Years and Over
I have read and understood the information on this form and the coach has satisfactorily answered any questions I have asked. I understand and agree that I participate in coached sessions and/or training prescription entirely at my own risk. I have considered the nature of such sessions; I will participate in a safe manner and follow all reasonable instructions from the coach. I confirm that the information I have provided is correct and complete to the best of my knowledge.
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7. Parental/Guardian/Carer Consent for Riders Under the Age of 18
I have read and understood the information on this form and the coach has satisfactorily answered any questions I have asked. I understand and agree that my child participates in coached sessions and/or training prescription entirely at their own risk. I confirm that the information I have provided is correct and complete to the best of my knowledge.
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Relationship to the rider
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