NTA / UCD Bike Library Sign-Up Form

NTA / UCD Bike Library

Sign-Up Form
Please complete the form below to apply to participate in the GAA Bike Library. Once you have submitted the form you will be contacted by a member of staff from Bleeper, which manages and maintains the Bike Library.
Club Name*
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email Address*
example@example.com
Q1.)Have you cycled an ebike previously?*

YesNo
Q2.)What type of bicycle storage space do you have in your home?(Select all that apply)*

Secure Shed/GarageSecure Back GardenUnsecure Back GardenUnsecure Front GardenIndoor Storage, e.g HallwayOther...
Q3.)What type of bicycle storage space do you have in your workplace? (If applicable)*

Secure Cycle Parking Facility (Keycard/Key access)Cycle Parking Stands (Public area, e.g. surface car park)Underground Car Park with Cycle Parking StandsIndoor Storage, e.g. Inside an officeNoneOther....
Q4.)How far from your child's club do you live?*

Within 2km2km-5km5km-10km10km+
Q5.)How many children would you like to transport with the ebike or cargo bike that you will borrow?*

0 (I will cycle alongside my child).2133+

Q6.)What age is your child?

Q7.)Do you require a child seat, max weight limited (22kg)?*

YesNo
Q8.)What type of bike would you prefer to borrow? Drag each type to the desired position below. (We cannot guarantee that you will receive your first preference, and the exact model may not match the pictures shown below.) *
Are you certain that you have placed your first choice in the correct position above?*

YesNo
Should be Empty: