To ensure our youngest participants remain safe, the following special requirements for cyclists under the age of 18 active in Club rides:

• All riders must be at least 12 years of age on or before event day unless otherwise stated on Ride Calendar and/or designated by Ride Leader
• Exception:  All ages are permitted on officially designated Family Rides unless otherwise stated and/or designated by Ride Leader
• All youth cyclists (ages 12-17) must review the Club’s Ride Group Best Practices with a parent or guardian before participating 
• All youth participants must have an additional Minor Permission Form completed by parent/guardian and given to Ride Leader
• Youth riders must be accompanied by a parent or responsible adult (at least 21 years of age) at all times
• One parent/adult may be responsible for no more than 3 youth riders
• All the above requirements apply for children on a tandem bicycles
• Trailers, tagalongs or child carriers are not allowed on the regular Club routes, but are allowed in major event rides
• Exceptions:  Trailers, tagalongs and child carriers are permitted on officially designated Family Rides unless otherwise stated and/or designated by Ride Leader.

Minor child participation permission

Date(Required)

MM slash DD slash YYYY

Event(Required)

Minor Child Name(Required)

First Last

Age(Required)

Please enter a number from 0 to 18.

Parent/Guardian Name(Required)

First Last

Parent/Guardian Signature(Required)

Event Adult Participant Name(Required)

First Last

Parent/Guardian Approval(Required)

I approve

By approving this form I am attesting to the fact that I understand and agree to all conditions set forth on this form and that if I have not understood any information, I have sought and received an explanation, and am fully aware that I am granting permission for the above-named minor child to participate in the White Clay Bicycle Club activity.

Permission to Participate(Required)

I give permission

I hereby give my permission for the above-named minor child to participate in the designated White Clay Bicycle Club cycling activity.

Permission for Emergency Medical Care and Conveyance(Required)

I give permission

I further grant permission for my son/daughter/minor child, named above, in case of injury as a result of athletic participation, to be given emergency attention/care and to be conveyed to an emergency medical facility, if needed. I understand that all medical costs that could occur of such conveyance and subsequent treatment are the sole responsibility of the parents/guardians, and I understand that White Clay Bicycle Club will assume no liability for the cost of said conveyance or treatment.

Informed Consent(Required)

I understand

I understand that injuries could occur as a result of participation in cycling activities. I understand that these injuries could include minor injuries such as bruises or abrasions, muscle strains, sprains, or broken limbs. I understand that it is possible that a catastrophic injury could occur rendering my son/daughter/minor child paralyzed, and that death could also occur as a result of a catastrophic injury.

CAPTCHA

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