Go Ride Parental Consent Form

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British Cycling Go-Ride Clubmark Club



    Emergency contact details

    Emergency Contact 1

    Emergency Contact 2

    Medical Information

    Disability Information


    It is necessary to obtain consent for your child to take part in a Bolsover & District Cycling Club Go-Ride session during 2021 at venues deemed suitable for coaching purposes. If you wish for your son/daughter to participate, then please read the following information, complete the form and the parental consent notice.

    All Go-Ride coaches are fully qualified British Cycling coaches that have received training in safeguarding and protecting children, and have been checked and cleared through the Disclosure and Barring Service. All fully qualified British Cycling coaches benefit from third party public liability and professional indemnity insurance cover.

    Any information provided about your child will be securely and confidentially stored, processed and destroyed by Bolsover & District Cycling Club in accordance with the principles of the Data Protection Act. It will only be used for the purpose of contacting you or your child regarding future Go-Ride events or other club events where your child could get involved in cycling; or to provide you with information about British Cycling membership.

    With your permission, Bolsover & District Cycling Club may also take photographs / video footage during the Go-Ride activity. These images may be used in coaching resources or placed on the Bolsover & District Cycling Club website or social media, or for general publicity purposes.


    Parental Consent Notice

    • I have read the information contained in this form and declare that I have the right to give parental consent, and hereby consent to my child taking part in the Go-Ride activity.

    • I confirm to the best of my knowledge that my child in my care does not suffer from any medical condition other than those detailed in this form.

    Equality monitoring information





    Black or Black British

    Other Ethnic Groups

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