LTR Reservation Ottawa-Gatineau-Halifax

Learn to Ride in Ottawa ON, Gatineau Quebec, Halifax Nova Scotia this summer on select days only. Fill out the reservation form to select your date preference, time and type of training......

LTR Reservation Ottawa-Gatineau-Halifax

Please note that all fields followed by an asterisk must be filled in.

I have Chosen

	The EQUAL PAYMENT PLAN
	TO GET STARTED NOW! ON LEARNING TO RIDE, Want to schedule a date
	REDUCED PRIVATE LESSONS OTTAWA

Training Location*

ADDITIONAL TRAINING CITIES LIMITED DATES/TIMES (subject to approval)

CUSTOMER, First and Last Name*

Last Name*

Cell Phone 1-*

Alternative Phone 1-

E-Mail Address*

Street Address

C I T Y and Postal / Zip Code*

Best days & hours to Call you (example: Mon 2:30 AM - 11:45PM)*

1. Cell Phone# on the day of the training?

2. Student(s) Full Name**

I agree to provide *

For standardization of proper fit I WILL USE THE Imperial system, TO PROVIDE ALL MEASUREMENTS ON THIS FORM IN : Feet - inches and LBS

Students Gender*

	Male
	Female

3. Student(s) Age*

4. Student(s) Height (inches"), *

5. Student(s) Weight (lbs)*

6. Student(s) Inseam **CRITICAL** (foot to highest point between legs) Inches" TO ENSURE TOP TUBE CLEARANCE ON TRAINING BICYCLE

	have included an inseam measurement in INCHES only
	will provide an inseam measurement (INCHES only) within the next 24 hours, or I will have to re-apply for another Learn To Ride session

Additional students

7. Type of Training*

	Private L-Ride Pkg 1st Time: 2hr 1st time + 1-1/2hr session
	Priv. Tri-Trn'g pkg: 2 hr 1st time+ two 1-1/2hr sessions
	Priv.Dual Tri-Trn'g pkg: two 2 hr 1st time+four 1-1/2hr sessions
	Private 2 hour Learn To Ride Session (Ottawa only) Subject to approval
	Private 1-1/2 hour Learn To Ride Session Available after any 2 hour session (Ottawa only) Subject to approval
	Youth 2 Children 13yrs or less L-Ride Pkg: 3 hr session
	Youth 2 Children 13 yrs or less L-Ride Pkg: 3 hrs + 1-1/2hr session
	Youth Tri-Trn'g Pkg 2 kids 13yrs or less, three - 3hour sessions
	YOUTH 2 TEENS 14-18yrs L-Ride Pkg 3 hr session
	YOUTH 2 Teens 13-18 yrs L-Ride Pkg: 3hours + 1-1/2hr session
	YOUTH Tri-Trn'g Pkg 2 TEENS Age 14-18yrs, three - 3 hour session
	YOUTH with one Adult 19yrs+ L-Ride Pkg: 1-1/2 hr session
	REDUCED PRIVATE LESSONS OTTAWA (fast pace condensed)

8. Other training

9. Preferred dates*

	Ottawa/Gatineau: Friday. June 25- Wednesday June 30 2021
	Ottawa/Gatineau: Friday July 9- Wednesday July 14 2021
	Ottawa/Gatineau: Friday August 27 - Wednesday September 1 2021
	Ottawa/Gatineau: Friday September 10 - Wednesday September 15 2021
	Halifax N.S.: Fri .July 2 - Tuesday July 6 2021
	Halifax N.S.: Friday September 3 - Tuesday September 7 2021
	Other Requested dates (add'l fees apply)

10. Dates, Special Requests

11. Day(s) of week preferred*

	Monday
	Tuesday
	Wednesday
	Thursday
	Friday
	Saturday
	Sunday

12. Preferred Time(s) of Training (give 2)*

	4-6am
	6-8am
	9am-11am
	10am-12pm
	1-3pm
	2-4pm
	6-8pm
	7-9pm

14. I will need

	bicycle(s) for training
	my bicycle tuned up or serviced prior to session, I will complete a Mobile bicycle service form and make payment for a Tune up (Refer to BICYCLE REPAIRS PAGE)
	to rent additional bicycles for friends and/or family (must be pre booked prior to June 20th

15. I accept*

If I bring my own bike, it has to be in riding condition or there will be additional charges to my account.

16. Helmet options*

	I will supply my own helmet(s)
	I will need a helmet(s)
	8 years or younger, I will supply helmet

17. STUDENT Helmet size (Teens - Adult)

	Small
	Medium
	Large

Additional Students information

19. Why do you feel, you need training?

20. What motivates you (student) to learn to ride a bicycle?

21. I wish to experience

	Road Cycling
	Mountain Biking
	Touring on distance rides using Hybrid or Road Bicycles
	Unicycling
	Other

22. I wish to CYCLE*

	within the neighbourhood and streets close bye
	On manicured crushed stone & Paved pathways
	Mountain bike trails in forests
	Road & Country cycling
	City road with traffic
	Cycling downtown core of city (ie.Torornto)
	Casual to the park and back
	Cycle waterfront trails along paved pathways

23. Choose what best describe Your scenario*

	I am a parent frustrated with my childs behavior, not wanting to learn to ride a bicycle
	I never had the chance to learn to ride a bicycle
	I had a bad experience, and never went back to riding a bicycle
	I've been told I don't have the ability to ride a bicycle
	I feel I must be in control at all times, I have to know the outcome, before I will step out on FAITH.
	I'd like to enhance my riding skills to a much higher level.
	Other

23a. Other

24. I want to be able to cycle?

	within the neighbourhood and streets close bye
	Manicured crushed stone & Paved pathways
	Mountain bike trails in forests
	Road & Country cycling
	City road with traffic
	Cycling downtown core of city (ie.Toronto)
	Casual to the park and back
	Cycle waterfront trails along paved pathways

25. What type of cycling do you want to experience?

	Road
	MTB (Mountain Biking)
	Touring, distance rides using Touring, Hybrid or Road bicycle
	Rail trails and manicured pathways
	Waterfront trails & pathways
	Other

25a. Other

26. Rank your Pain Factor*

26a. Other

27. Does the student have a learning disability, mental or physical chalenges?**

	YES
	NO

28. Does the Student(s) have any health issues, if yes, you may be required to complete an assessment.**

	YES
	NO

29. If "Yes" please specifiy , also, add a website link for more information on this topic.

30. I agree to the following*

I realize by completing this form, I accept all risks, inherent injuries, and waive all liabilities and compensations from Born To Ride Bicycle and/or their employees, as well as all organizations/persons that own or manage the lands, that we use for training.

31. I acknowledge*

We all grow and mature through perseverance, when you make mistakes you learn, when you learn from your mistakes, you develop experience, and become better equipped for life's challenges. In education you learn from others. Other people’s experiences, that they have had made mistakes (trial and error) to attain knowledge. We combine both Experience and knowledge to help you accomplish your goals by taking action. By working with our trainers and having faith, believing you can achieve and actually doing it, you create a higher level of confidence and belief. As you venture more into new experiences, your knowledge and experience accelerates, becoming more successful in life! Eventually you will inspire others to do the same. We look forward to seeing you soon!

32. I agree to the following*

I do not and will not hold Born To Ride Bicycle or its employees liable for any mental stress or physical injuries. I agree that my trainer has my permission to use any or all techniques and methods to help inspire, motivate, not limited to causing emotional onsets that maybe beyond my comprehension but yield successful results, by encouraging mental growth and developing successful skill sets, in the form of becoming a cyclist and a stronger personality. We define this as strong leadership skill.

33. I realize*

When raised in certain environments that lack discipline and/or expectations, or if a student spends any time in a online virtual world (gaming, social media); there mindset and perceptions will heighten levels of stress outside of that environment due to poor real life experiences, and will create disconnection from family members, limited flexibility, adaptability to change inability to control their emotions and can even result in similar characteristics to drug addiction. And if not corrected early can result in weak will power over come life’s everyday challenges, and/or mental breakdown in some form.

34. I accept that*

Under extreme scenarios to help the student grow, we may trigger the student to experience emotional onsets, that help the student release stressors getting over certain stumbling blocks, that help them mature, and in other rare scenarios the student can be very stubborn not willing to accept their present environment, and in most cases we will need to extend the number of training sessions, and there intensity, sometimes with the help of the parent(s) putting barriers or restrictions in place to change the students behavior’s, before, during and after each session.

35. I acknowledge:*

To successfully move forward, your trainer will expect performance and consistent improvements and adaptability, or he will have no choice but to increase the number of sessions to suit the student’s learning curve, with the goal of yielding results.

36. I accept that*

Our trainers encourage perseverance, are very patient, and nurture successful achievements. I realize, A person will take longer to learn new skills, If they lack Life skills, Life skills are developed by been exposed to multiple sports, athletic experiences, and hands on activities

In preparation for my training session(s), I will complete the following activities sports and/or exercises *

	Swimming 2-4 laps within 10 minutes
	Swimming 3-5 laps within 15 minutes
	Swimming 5-10 laps within 30 minutes
	Swimming 10-15 laps within 40 minutes
	Swimming 15-25 laps or more within 60 minutes
	I dont know how to swim
	roller blading
	I dont how to roller blade
	Running / jogging 2-5 kilometers within 30 minutes
	Running / jogging 5-10 kilometers 50 minutes
	Running / jogging 10-20 kilometers within 100 minutes
	Running / jogging 20-50 kilometers within 250 minutes
	Swinging on a swing with no assistance, combined with other outdoor sports for a minimum of 2 hours
	climbing monkey bars combined with other outdoor sports for 2 hours
	mountain climbing
	Climbing trees combined with other high cardio exercise's for 2 hours
	1-1/2 hour spinning classes
	2 hour spinning classes
	3 hour spinning classes
	walking up and down 4 -6 flights of stairs for 2 hours
	walking up and down 10-20 flights of stairs for 2 hours
	walking or hiking 20-40 kms
	playing basket ball for 2 hours non-stop
	Soccer for 2 hours non-stop
	parkour
	ALL Assigned exercise's mentioned in the Confirmation email
	other high cardio/intensity sports for 1-1/2-2hours, non stop

Other Cardio/intensity

How often will you complete the above sports/exercises prior to your session*

	1-2 times
	3-5 times
	6-9 times
	10-12 times
	13-15 times
	16-20 times
	other

Other

When I finally meet*

My trainer, I will provide a report on my accomplishments on the sports/exercises I completed prior to the session.

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est. 2009

10 YEARS+

IN BUSINESS

1-855-795-4482

We Service

CENTRAL ONTARIO

OTTAWA, GATINEAU QUEBEC

LTR Reservation Ottawa-Gatineau-Halifax

LTR Reservation Ottawa-Gatineau-Halifax

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