SLHB Client Details Form

Please complete our ability quiz piror to completing this form if you are unsure of your ability level

TAKE QUIZ HERE

Name*

First NameLast Name

Date of Birth *

DD/MM/YYYY

Phone Number*

Country CodePhone Number

Email*

example@example.com

Ability Level to your best judgement (if unsure - take our ability guide on our website)*

BeginnerIntermediateAdvancedExpert

Weight (kg)*

Height (cm)*

Emergency Contact Name*

Emergency Contact Phone Number*

Do you have any medical/dietary conditions that we should know about? Are you taking any medication?*

YesNo

If you answered yes, please provide further detail:

Bike Equipment: Our team advises the use of a dual suspension bike (e-bike or standard). We also recommend having your personal bike serviced prior to your trip with us. Select bike equipment requirements:*

I will be using my own bikeI would like to hire an E-bike

I prefer to have my front break on: (USA and North America Typically have front breaks on Left Hand)*

Left HandRight Hand

If you are supplying your own bike please provide details (make, model, size. weight etc.)

For use of personal equipment:*

I understand that Southern Lakes Helibike is not liable for any equipment damage or mechanical issues to my bike. I will ensure my bike is in adequate condition prior to my trip's departure.