Torbay u3a Social E-Biking Group
Participant Acknowledgment & Contact Form
1. Personal & Emergency Details
Full Name
*
First Name
Last Name
Torbay u3a Membership Number
Mobile Phone Number
*
Emergency Contact Name & Relationship:
Emergency Contact Phone Number:
2. Rider & E-Bike Responsibilities
E-Bike Roadworthiness
*
I confirm my e-bike is legally compliant (EPAC rules: max 250W, motor assistance up to 15.5 mph), fully roadworthy, and that brakes, tires, and battery are in safe working order.
Personal Fitness & Health
*
I confirm I am physically capable of participating in group cycle rides. I will inform the Group Leader confidentially if I have any medical condition that may affect my safety during a ride.
Protective Gear & Equipment
*
I agree to wear an approved cycling helmet and appropriate clothing during all group rides, and carry basic repair supplies (e.g., spare inner tube/pump) suitable for my bike.
Highway Code & Safety
*
I agree to follow the UK Highway Code, follow safety instructions given by the Group Leader, and ride responsibly within the group.
3. Risk Acknowledgment
I acknowledge that cycling carries inherent risks of accidental injury or property damage. I accept responsibility for my own safety, my personal equipment, and my riding behaviour during u3a e-bike group activities.
Signature
*
Date
*
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Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
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