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......

This Form cannot be submitted until the missing fields (labelled below in red) have been filled in
Registration Ottawa-Gatineau-Montreal-Halifax
Please note that all fields followed by an asterisk must be filled in.
I have Chosen	TO GET STARTED NOW! ON LEARNING TO RIDE, Want to schedule a date IMPROVE MY CYCLING SKILLS The EQUAL PAYMENT PLAN OTTAWA/GATINEAU
Training Location*
---Select---OTTAWA - Downtown OTTAWA - Ontario KANATA- Ontario GLOUCESTER- Ottawa NEPEAN - Ontario - 15 km South of Ottawa NEPEAN - Ontario 15 km South of Ottawa, if there no availability here, I will come to Gatineau Quebec, 15 km North of Ottawa GATINEAU - Quebec 15 km North of Ottawa GATINEAU - Quebec 15 km North of Ottawa, if there no availability here , I will come to Nepean Ontario, 15 km South of Ottawa KIRKLAND - Quebec SENNEVILLE - Kirkland SAINTE-ANNE-DE-BELLEVUE MONTREAL QC - Downtown DORION / Vaudreuil - Quebec CORNWALLL - Ontario Other Location, with this option I will provide a location that meets Born To Ride Bicycle's REQUIREMENTS HALIFAX - Nova Scotia DARTMOUTH - Nova Scotia
7. Type of Training*	Cycle Safety Training Techniques, Control, Interpretation, Communication Tri-Trn'g pkg: 2 hr 1st time+ two 1-1/2hr sessions PENTATRACK-TRAIN’G PKG 1-30 MINUTYE PREP/EXERCISE + FIVE 1-1/2 HR MOMENTUM PKG 1-30 MIN+1-2HR 1ST TIME+FOUR 1-1/4 HOUR S'SSN CHILDREN PKG 1-2 HR + FIVE 1-1/4HOUR S'SSNS CHALLENGING CHILDRENS PKG 1-30MIN+1 1-1/2HOUR+6 1-1/4 HOUR S'SSN ONE 3 HOUR TWO STUDENT PKG TWO 3 HOUR TWO STUDENT PKG THREE 3 HOUR TWO STUDENT PKG ASSESSMENT 45 MINUTES limited available dates/times 2 hour Learn To Ride Session (Ottawa only) Subject to approval 1-1/2 hour Learn To Ride Session Available after any 2 hour session (Ottawa only) Subject to approval L-Ride Pkg two - 3 hrs + 1-1/2hr session YOUTH with one Adult 19yrs+ L-Ride Pkg: 1-1/2 hr session OTHER
Other
ADDITIONAL CITIES (Subject to approval)
---Select---PICKERING - STUDENT PROVIDES LOCATION AJAX - STUDENT PROVIDES LOCATION WHITBY - STUDENT PROVIDES LOCATION OSHAWA - STUDENT PROVIDES LOCATION BOWMANVILLE - STUDENT PROVIDES LOCATION NEWVCASTLE - STUDENT PROVIDES LOCATION BELLVILLE - STUDENT PROVIDES LOCATION NAPANEE - STUDENT PROVIDES LOCATION KINGSTON - STUDENT PROVIDES LOCATION GANANOQUE - STUDENT PROVIDES LOCATION DARLINGSIDE - STUDENT PROVIDES LOCATION BROCKVILLE - STUDENT PROVIDES LOCATION IROQUOIS - STUDENT PROVIDES LOCATION
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*
1. Cell Phone# on the day of the training
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
STUDENT
2. Student(s) Full Name**
Students Gender*	Male Female
OTHER
3. Student(s) Age*
4. Student(s) Height (inches")*
5. Student(s) Weight (lbs)*
6. Student(s) **CRITICAL** (measure floor to highest point between legs) Inches" TO ENSURE TOP TUBE CLEARANCE ON TRAINING BICYCLE INSEAM (INCHES")
I*	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
8. Other training
9. Preferred dates*	Thursday April 21 - Thursday April 28 2022 Thursday May 19 - Thursday May 26 2022 Thursday June 23- Thursday June 30 2022 Thursday July 21 - Thursday July 28 2022 Thursday August 18 - Thursday August 25 2022 Halifax N.S.: Thursday Thursday June 30 - July 4 2022 Halifax N.S.: Fri. July 28 - Sun July 31 2022 Halifax N.S.: Thursday August 25 - Thursday September 1 2022 Other Requested dates (add'l fees apply)
10. Dates, Special Requests
11. Preferred Day(s)*	Monday Tuesday Wednesday Thursday Friday Saturday Sunday
12. Preferred Time(s) two 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 (minimum pre booked 2 weeks prior.)
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?
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
21. I wish to experience	Road Cycling Mountain Biking Touring on distance rides using Hybrid or Road Bicycles Unicycling Cycle within the neighborhood and streets close bye Ride On manicured crushed stone & Paved pathways Mountain bike trails in forests Road & Country cycling Ride in City road with traffic Cycling downtown core of city (ie.Torornto) Casual to the park and back Cycle waterfront trails along paved pathways Other
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
23a. Other
25a. Other
26. Rank your Pain Factor*	---Select---I am constantly taking pain killers I fall apart at the first onset of any discomfort or pain If I'm not comfortable, I feel, I can't do it If I get a scratch, I feel I need immediate attention I don't see the benefit of discomfort or pain I can withstand a scratch, bruise or fall here or there Anything worthwhile involves experiencing some form of discomfort or pain Discomfort or pain doesn't bother me No Pain, No Gain I am athletic, and work out on a regular basis. PAIN = GAIN Life's full of risks, and I'm willing to take it all on!
26a. Other
27. Does the student have a learning disability, mental or physical challenges*	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 specify , 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 share my accomplishments on the sports/exercises I completed prior to the session.
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