Screen Reader Mode Icon

Register now to secure your spot in Bicycle Network's Mum's on Bike Program

Question Title

* 1. Please share your contact details so we can provide you with the details of the program

Question Title

* 2. Have you ever ridden a bike before?

Question Title

* 3. If answered yes to question 3 - What is your level of bike riding?

Question Title

* 4. Would you like us to provide you with any of the following equipment

Question Title

* 5. If you will be bringing children to the program would you like to access the onsite free babysitting service while you take part in the program?

Question Title

* 6. If answered yes to question 5 - What are the age/s of your child/ren

Question Title

* 7. Do you have any health conditions that Bicycle Network needs to be made aware of?

Question Title

* 8. If answered yes to question 7 - Can you please share the details of the condition

Question Title

* 9. What are the details of your emergency contact person - Name and Phone number

T