The Adventure Girls Club & dirtShe Health & Contact Form Adventure Girls Pre-ride details needed Your Name(Required) First Last What kind of riding have you done?(Required) Road, towpaths, etcWhat are you hoping to get out of the ride?(Required) Your height(Required) This is needed for the correct size of hire bike.Emergency Contact Details(Required) First Last Emergency Contact Phone(Required)There will be cake or flapjacks! Any dietary requirements?(Required) Medical ConditionsDo you suffer from any of the following? Tick all that apply. Leave blank otherwise. Epilepsy, Convulsions or Petit Mal Diabetes Mellitus (high/low sugar) Asthma Heart Disease Are you recovering from a broken limb or other injury? Are you on medication? Any known allergies? Please explain ticks above and include any other health information that may be useful.Consent(Required) I confirm the information I provided is accurate and I agree to the ride policies & waiver below.Your Consent I, the undersigned, have detailed all my medical conditions, which may be of concern to B Perrou (DirtShe Nomad). I consent to taking part in the guided ride I have applied for. I understand this to include any emergency first aid treatment provided with best intention by any qualified staff involved. I understand that the guiding staff will make every reasonable effort to contact me and /or my next of kin as soon as reasonably possible regarding such treatment. Mountain biking is an extreme sport, and carries an amount of risk, in the event of injury to myself/others, I therefore do not hold B Perrou or other staff accountable, and partake in the activity at my own risk. Further details can be found here.
