Learn to Ride Parent Registration

You Can Ride 2

We are not able to supply bicycles for this program.
(at this time, you will be asked to sign a waiver and pay a $100 refundable deposit)
Classes run from 6-7 pm or 7-8 pm, depending on your child's needs.
Therapist Information
Registration Information (Child)
Primary Contact Information
Parent/Guardian 1
Parent/Guardian 2
Alternative Pick-up
Emergency Contact
Medical Diagnosis Information
(i.e., Asthma, Developmental Coordination Disorder, Cerebral Palsy, Diabetes, ADD, Anxiety, etc.)
Social Worker
Additional Information
(e.g., seizure medication)
(i.e., learning disability, behaviours, language delay, cognitive delay)
Background Information
(e.g., running beside the bike, taking off pedals, other biking groups, gyrowheel)?
(e.g., fear of falling, tires easily, distractibility, poor balance, etc.)
1 = Not at all important
10 = Extremely important
1 = Not at all important
10 = Extremely important
1 = Unable
10 = Proficient
1 = Unsatisfied
10 = Extremely satisfied
(e.g., reward strategies, strong interests that help with motivation, skills they are particularly good at)
e.g., on the sidewalk only, on trails, on the roads

Please note that the information you provide may also be maintained for an indefinite period by the organization in anonymized form for general purposes, including in order to allow for program assessment and improvement, allow for research and/or study, and/or grant and financing application purposes. If you have any questions, please contact us at YCR2@edmontonbikes.ca.