Current Contact Details About You Loan Details Session Details Your Cycling Terms and Conditions Complete Who will see this information? This project is run by Cycling UK, in consultation with Wheels for Wellbeing. Cycling UK are the data controllers and Wheels for Wellbeing are joint data processors. This means that Cycling UK will only share your data with Wheels for Wellbeing to monitor and evaluate the project and support our organisations to continue removing barriers for disabled people to access cycling. Your data will not be shared with any other third parties. Privacy policyCycling UK (“we”, “us”, or “our”) is committed to protecting and respecting the personal data that we hold. If at anytime you would like to remove your data, please contact: inclusivecycling@cyclinguk.org . If you have questions about our policies, please contact Cycling UK’s Data Protection Officer: dpo@cyclinguk.org . A full copy of our Privacy and Data Protection Policy can be found at www.cyclinguk.org/privacy Wheels for Wellbeing’s Privacy Policy can be found here: Campaigning for inclusive cycling, Wheels for Wellbeing Is this booking for you or on behalf of someone else? This booking is for myself This booking is for someone else Your details First name Last name Email address Phone Number Gender Gender - None -FemaleMalePrefer not to sayOther… Enter other… Are you 18 years old or older? Yes No You must be at least 16 years old to participate. If you are 16 or 17 years old, you must have parental consent. You will be asked to provide parental consent prior to the session/loan. Your details First name Last name Email address Phone Number Participant Details First name Last name Gender Gender - None -FemaleMalePrefer not to sayOther… Enter other… Is the participant 18 years old or older? Yes No They must be at least 16 years old to participate. If they are 16 or 17 years old, they must have parental consent. They will be asked to provide parental consent prior to the session/loan. Address Address : Line 1 Address : Line 2 Town County Postcode Challenging behaviours challenging_behaviours Does the participant show any challenging behaviours? Yes No Please provide details Please answer the following questions from the perspective of the person who will attend the session or loan. Leave this field blank Share: