Kids Intro Form – Trailhead Coaching

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Kids Intro Form

Kids Intro Form

Newsletter

Rider's Name

Pronouns e.g. she/her; he/him; they/them; other - please describe what you use. We collect this information so that we can support your child's inclusion in our program.

Gender (e.g. boy, girl, non-binary, other)

If you suffer from any medical conditions or acute injuries please list them below

We welcome you to tell us your childs 'super power' (e.g. Autism, ADHD, Dyslexia, Downs Syndrome) if you think it may assist us in supporting their participation

Contact Email

Emergency contact name

Emergency contact phone

If part of a group, who's the main contact?

How old are you?

For how long have you been riding?

Skill level - please refer to our 'Kids Rider Level' descriptors here: https://trailheadcoaching.com.au/kids-rider-levels/

Dirt Rider

Rad Rider

Flow Rider

Shred Rider

What sort of brakes does your bike have?

Balance bike

Fixed gear pedal bike with back pedal brakes

Geared bike with hand operated brakes and gears

Hard tail MTB with hand operated brakes (disc optional), at least 8 gears and front suspension forks

Dual suspension MTB with disc brakes, at least 10 gears and a dropper seat post (optional)

Which trails/where do you normally ride?

Please list any other sports you enjoy.

What skills specifically would you like to learn? What are your goals for the coaching session?

Do you consent to your child's image being used to promote participation in MTB for promotional material including but not limited to social media, website and printed material?

Yes

No

Any other comments or requests?

I have read and agree to the Trailhead's Child/Youth Safety & Wellbeing Policy

I have read and accept the terms and conditions.

[email protected]
0400 871 803

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Castlemaine
Harcourt

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