Captain's Registration
Form description
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First Name *
Last Name *
Street Address *
City *
Province
Postal Code *
Primary Phone Number *
Cell Phone number is preferred if any contact is required while riding. Please enter digits and hyphens (e.g. 555-555-5555).
Text Messaging *
Is this number capable of receiving text messages? Yes or No.
Phone 2
Enter an alternate phone number here. Please enter digits separated by hyphens (e.g. 555-555-5555).
Email *
Would you like to receive announcements about upcoming TRAILBLAZERS
group rides and other events via e-mail?
Clear selection
Age Category
For statistical purposes only.  
Age 16-19
Age 20-24
Age 25-64
Age 65+
Height (feet, inches) *
Weight (lbs) *
Experience
Have you ridden a tandem before? Yes or No.
Clear selection
Volunteer
Have you volunteered anywhere else? Yes or No.
Clear selection
Explain
If yes, please explain any volunteer experience.
In Case of Emergency (Mandatory, please complete)
Emergency Contact: Name *
Emergency Contact Name
Emergency Contact: Relationship
What is your relationship with the above person?
Emergency Contact: Phone Number *
Emergency Contact Phone Number. Please enter digits and hyphens (e.g. 555-555-5555).
Contact 2 Name
Is there an alternate contact we could call?
Contact 2 Phone
Please enter digits and hyphens (e.g. 555-555-5555).
Sheds
Please indicate which sheds or areas you are interested in riding from. This does not limit your choices in the future.
CNIB
Near Bayview and Eglinton
EAST SHED
Near Kennedy Subway Station
FERRY DOCKS
Toronto Island Ferries Queens Quay and Bay St.
MISSISSAUGA SHED
Near Burnhamthorpe Rd E. and Hurontario Street
SOUTH SHED
Near Royal York and Lakeshore
WEST SHED
Near Burnhamthorpe and West Mall, Etobicoke
Your Riding Schedule
Please indicate when you are most likely to be available. Again, you are not restricted by your choices in the future.
WEEKDAYS
EVENINGS
WEEKENDS
IMPORTANT
As bicycles are considered Vehicles, all persons riding on the front of a club tandem must comply with Ontario Regulation 340/94. This specifies basic medical standards which must be met for the operation of a vehicle. Any person who is aware, or becomes aware of any condition that would prohibit operation of a vehicle under the regulation, is required to advise the club of such condition.
Health *
Are there any Health issues we should be aware of? (e.g. Epilepsy, Diabetes, Asthma, Heart, etc.)
Explain
If yes, please explain briefly. You may talk to us later.
References
Please provide a reference if you have not already been registered with us.
Reference: Name
Reference: Relationship to you
Reference: Telephone
Please enter digits and hyphens (e.g. 555-555-5555).
Thank you.
We will be in contact with you. Please remember that we will need an original, signed copy of our Waiver Form to be submitted via email to the address shown at the bottom of the waiver (found here on our site), or provided to us at the time of the Orientation session.

While you are waiting for us to contact you, please visit us on YouTube and watch our instructional videos here:
https://www.youtube.com/channel/UCL0CKi8Icfx48IFCraZgVUg  (click this link now and then save to your favourites to view later.)
Comments
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