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ACKNOWLEDGEMENT AND ASSUMPTION OF RISK FORM

Bike rental

(Mechanical or electric, fat bike or urban)

In downtown Quebec City or mobile fleet

Valid from April 2024 to November 2024



IMPORTANT

  • Each participant from your group must fill out this form to participate in the activity.
  • Participants under 18 years old (minors)

This form must be completed and signed by a legal guardian if the participant is under the age of 18. Please select Minor in the Participant's health profile & bike experience section. If you are filling out this form for your child, please fill it out in his/her presence to make them aware of their responsibilities. You may complete this form for more than one minor at a time. All minors must be accompanied by an adult.

  • Participants of 18 years old and older (adults)

Please select Adult in the Participant's health profile & bike experience section. PLEASE FILL OUT YOUR OWN FORM (NOT FOR OTHER PARTICIPANTS).

ELECTRIC BIKE - 18 years and over only : In Quebec, it is possible to drive an electric bicycle from the age of 14, but the cyclist must hold a class 6D license authorizing the driving of a moped according to road safety regulations. From the age of 18, no license is required. For this reason, our electric bike rentals are only available to those aged 18 and over. Helmets must be worn.


Risks inherent to the activity

The risks inherent to the activity in which I will participate are, in particular, but not limited to :

  • Injuries due to falls or other movements, (sprain, strain, fracture, etc.);
  • Injuries with blunt or sharp object (branches, material, etc.);
  • Frostbite, hypothermia and/or other cold induced injuries;
  • Injuries resulting from accidental collision or other contact between individuals (cars or other users of the road);
  • Food allergy;
  • Getting lost;
  • Burns and/or other heat induced injuries.

I acknowledge that I have been informed of the risks inherent to the activities that are part of the Tuque & bicycle experiences inc. program.

Confirmation of information and assumption of risks

I certify that the information provided on this form and at the time of booking is accurate to the best of my knowledge. I certify that I have not deliberately omitted any information about my health condition, whether relevant or not (to be completed). I am aware that the information contained in this form and transmitted to the company is confidential and is intended to better plan and supervise the safety of the activities in which I will participate and that it will allow Tuque & bicycle expériences inc. to draw up a profile of its clientele. Having been made aware of these risks and having had the opportunity to discuss them with a person in charge of the activity if necessary, I acknowledge that I have been informed of the risks inherent to the activities and that I am able to undertake the activity or the stay in full knowledge of the facts and by accepting the risks that may be involved in this activity.

I also agree to play an active role in the management of these risks by adopting a preventive attitude towards myself and other people around me. Any team member of Tuque & bicycle expériences inc reserves the right to exclude any person he/she deems to be a risk to him/herself or to the rest of the group (without refund). I understand that I may leave this activity for any reason (safely and without refund).

Mandatory safety equipment

I agree to wear a valid (not expired) bicycle helmet for the duration of the activity. I also agree to wear closed shoes and clothing appropriate for the activity and weather conditions. 

Covid-19

There are risks of contracting Covid-19 in the context of your participation in the activity.

I commit myself to playing an active role in the management of these risks by adopting a preventive attitude towards myself and the other people around me. In other words, I will take the necessary preventive measures and I will NOT participate in the activity if I have any doubt that I have been in contact with a person who has tested positive for Covid-19, if I have any symptoms or if I have tested positive.

Drugs and Alcohol

I agree that I will not use, possess or be under the influence of any drugs, illicit substances or medications (prescription or otherwise) that are not listed in the HEALTH STATUS section.

I also confirm that I am not under the influence of alcohol and that I will remain so for the duration of the activity. I am aware that any breach of these rules on my part may result in my expulsion without notice and without the possibility of a refund.

Material responsibility

By participating in the activity, I commit myself to use the equipment and accessories rented or lent with the greatest care and to follow the instructions. Also, I accept full responsibility for any loss caused by theft or any other cause and I agree to pay the cost of repairing or replacing the equipment and accessories rented and/or loaned to me that have been lost or damaged.

Furthermore, I, the undersigned, hereby waive any claim, as well as any lawsuit for damages for any damage to the goods and material belonging to me (normal wear and tear, loss, breakage, theft, vandalism).

Authorization to intervene in case of emergency

I, the undersigned, authorize Tuque & bicycle experiences inc. and any associated person (e.g. bicycle instructor) to provide any necessary first aid. I also authorize Tuque & bicycle expériences inc to make the decision, in the case of an accident, to transport me (by ambulance, helicopter, or otherwise) to a hospital or community health facility, all, if necessary, at my own expense.


RENTAL CONTRACT

Lessor's commitment

  • The lessor is committed to providing safe and good condition equipment.
  • The lessor is not responsible for any event (accidents, incidents, damages to property and equipment belonging to the lessee) during the rental period and is not responsible for any injuries or damages.
  • No refund will be made for early return.

Tenant’s commitment

  • I confirm I have the skills, knowledge and experience required to do the activity.
  • I acknowledge that I was informed about the risks inherent to the activities and I am able to participate in the activity WILLINGLY AND I ACCEPT ANY AND ALL RISKS THAT such an activity can comprise.
  • I undertake to use the safety equipment required and provided by the lessor : BICYCLE HELMET & LIGHTS (in the dark).
  • I acknowledge that the leased equipment has been provided in good condition or as specified on the equipment description sheet and undertake to return the leased equipment and accessories at the end of the contract to the lessor's place of business by notifying the person in charge of the rental and to return the equipment in the same condition and operating condition as when I took possession of it, except as a result of normal wear and tear.
  • I agree to use the equipment and accessories rented with the utmost care and is fully responsible for any loss caused by fire, theft or any other cause and thus agree to pay the cost of repair or replacement of the equipment and accessories rented having suffered loss or damage.
  • I agree to notify the lessor in writing and signed (paper or email) of any loss of rented equipment immediately after such loss, describing all circumstances during which it occurred, and also agree to notify the nearest police force within the same period.
  • I hereby waive any and all claims, as well as any and all lawsuits for damages to property and equipment belonging to me (normal wear and tear, loss, breakage, theft, vandalism).
  • I agree to make a deposit that will be refunded upon return of the rented items (leave a credit card number). In case of loss, damage or delay in returning the rented equipment, the deposit will be used by the lessor to pay the amount due.
  • I agree to pay in advance the rental fee stipulated at the beginning of each rental period and to pay upon return for the additional period used if it exceeds 15 minutes.
  • This contract is valid for the period mentioned in the reservation.
  • The tenant is not allowed to transport the bike with a vehicle. The only person authorized to transport the bicycle is the lessor.

I acknowledge that I have been informed by the lessor of the following points:

  • The inherent risks of the activity
  • Instructions on the use of the equipment and mandatory safety equipment
  • Communication instructions in case of emergency (911)
  • General safety instructions
  • Reminder of the end time of the activity.


Note: In this document, the use of the masculine gender to refer to individuals is intended to simplify the text.

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's health profile & bike experience

What is your height (cm/feet)? *
I confirm that I weigh less than the user weight limit of the bike manufacturer: 250 lbs/115 kg.*
Yes, I weigh less than 250 lbs/115 kg.
No, I weigh over than 250 lbs/115 kg.
Allergies and food restrictions?*
No
Yes

If yes, please specify :
Are you pregnant?*
No
Yes
Do you take any medication?*
No
Yes

If yes, please specify :
Do you have any physical, emotional or behavioural health problems that would directly or indirectly limit you in the activity you will be participating in? Specify, e.g. respiratory problems, heart problems, diabetes, vision problems, deafness, fear of water/heights/dogs, limitation of movement, etc.*
No
Yes

If yes, please specify :
N.B.: If you answered yes to any of the above questions, YOU MUST CONTACT AND INFORM TUQUE & BICYCLE EXPERIENCES AND THE INSTRUCTOR. After discussing this with the person in charge of the course, I accept the additional risk that could result in a possible worsening of my health condition.*
I accept.
I do not accept.
I answered NO to all questions.
I consider myself an active and healthy person.*
No
Yes

Anything else to specify?
How would you describe your overall cycling experience?*
None (I have never ridden a bike).
Beginner (I've been cycling for a long time.)
Beginner (I don't ride my bike very often and I don't feel totally comfortable riding at the moment).
Beginner (I feel comfortable riding, but I don't ride often.)
Intermediate (I ride my bike often.)
Advanced (I ride my bike very often.)

Anything else to add, comment or specify?
Have you ever tried e-biking?*
No
Yes

Anything else to add, comment or specify?
I accept that Tuque & bicycle experiences take pictures and videos of me to promote its activities.*
I accept.
Yes, but under certain conditions (please specify).
No, I do not accept under any condition.

Anything else to add, comment or specify?

Comments, suggestions
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*

Phone*
Second Participant's Date of Birth*
Second Participant's health profile & bike experience

What is your height (cm/feet)? *
I confirm that I weigh less than the user weight limit of the bike manufacturer: 250 lbs/115 kg.*
Yes, I weigh less than 250 lbs/115 kg.
No, I weigh over than 250 lbs/115 kg.
Allergies and food restrictions?*
No
Yes

If yes, please specify :
Are you pregnant?*
No
Yes
Do you take any medication?*
No
Yes

If yes, please specify :
Do you have any physical, emotional or behavioural health problems that would directly or indirectly limit you in the activity you will be participating in? Specify, e.g. respiratory problems, heart problems, diabetes, vision problems, deafness, fear of water/heights/dogs, limitation of movement, etc.*
No
Yes

If yes, please specify :
N.B.: If you answered yes to any of the above questions, YOU MUST CONTACT AND INFORM TUQUE & BICYCLE EXPERIENCES AND THE INSTRUCTOR. After discussing this with the person in charge of the course, I accept the additional risk that could result in a possible worsening of my health condition.*
I accept.
I do not accept.
I answered NO to all questions.
I consider myself an active and healthy person.*
No
Yes

Anything else to specify?
How would you describe your overall cycling experience?*
None (I have never ridden a bike).
Beginner (I've been cycling for a long time.)
Beginner (I don't ride my bike very often and I don't feel totally comfortable riding at the moment).
Beginner (I feel comfortable riding, but I don't ride often.)
Intermediate (I ride my bike often.)
Advanced (I ride my bike very often.)

Anything else to add, comment or specify?
Have you ever tried e-biking?*
No
Yes

Anything else to add, comment or specify?
I accept that Tuque & bicycle experiences take pictures and videos of me to promote its activities.*
I accept.
Yes, but under certain conditions (please specify).
No, I do not accept under any condition.

Anything else to add, comment or specify?

Comments, suggestions
Second Participant's Signature*
Third Participant's Name

First Name*

Last Name*

Phone*
Third Participant's Date of Birth*
Third Participant's health profile & bike experience

What is your height (cm/feet)? *
I confirm that I weigh less than the user weight limit of the bike manufacturer: 250 lbs/115 kg.*
Yes, I weigh less than 250 lbs/115 kg.
No, I weigh over than 250 lbs/115 kg.
Allergies and food restrictions?*
No
Yes

If yes, please specify :
Are you pregnant?*
No
Yes
Do you take any medication?*
No
Yes

If yes, please specify :
Do you have any physical, emotional or behavioural health problems that would directly or indirectly limit you in the activity you will be participating in? Specify, e.g. respiratory problems, heart problems, diabetes, vision problems, deafness, fear of water/heights/dogs, limitation of movement, etc.*
No
Yes

If yes, please specify :
N.B.: If you answered yes to any of the above questions, YOU MUST CONTACT AND INFORM TUQUE & BICYCLE EXPERIENCES AND THE INSTRUCTOR. After discussing this with the person in charge of the course, I accept the additional risk that could result in a possible worsening of my health condition.*
I accept.
I do not accept.
I answered NO to all questions.
I consider myself an active and healthy person.*
No
Yes

Anything else to specify?
How would you describe your overall cycling experience?*
None (I have never ridden a bike).
Beginner (I've been cycling for a long time.)
Beginner (I don't ride my bike very often and I don't feel totally comfortable riding at the moment).
Beginner (I feel comfortable riding, but I don't ride often.)
Intermediate (I ride my bike often.)
Advanced (I ride my bike very often.)

Anything else to add, comment or specify?
Have you ever tried e-biking?*
No
Yes

Anything else to add, comment or specify?
I accept that Tuque & bicycle experiences take pictures and videos of me to promote its activities.*
I accept.
Yes, but under certain conditions (please specify).
No, I do not accept under any condition.

Anything else to add, comment or specify?

Comments, suggestions
Third Participant's Signature*
Fourth Participant's Name

First Name*

Last Name*

Phone*
Fourth Participant's Date of Birth*
Fourth Participant's health profile & bike experience

What is your height (cm/feet)? *
I confirm that I weigh less than the user weight limit of the bike manufacturer: 250 lbs/115 kg.*
Yes, I weigh less than 250 lbs/115 kg.
No, I weigh over than 250 lbs/115 kg.
Allergies and food restrictions?*
No
Yes

If yes, please specify :
Are you pregnant?*
No
Yes
Do you take any medication?*
No
Yes

If yes, please specify :
Do you have any physical, emotional or behavioural health problems that would directly or indirectly limit you in the activity you will be participating in? Specify, e.g. respiratory problems, heart problems, diabetes, vision problems, deafness, fear of water/heights/dogs, limitation of movement, etc.*
No
Yes

If yes, please specify :
N.B.: If you answered yes to any of the above questions, YOU MUST CONTACT AND INFORM TUQUE & BICYCLE EXPERIENCES AND THE INSTRUCTOR. After discussing this with the person in charge of the course, I accept the additional risk that could result in a possible worsening of my health condition.*
I accept.
I do not accept.
I answered NO to all questions.
I consider myself an active and healthy person.*
No
Yes

Anything else to specify?
How would you describe your overall cycling experience?*
None (I have never ridden a bike).
Beginner (I've been cycling for a long time.)
Beginner (I don't ride my bike very often and I don't feel totally comfortable riding at the moment).
Beginner (I feel comfortable riding, but I don't ride often.)
Intermediate (I ride my bike often.)
Advanced (I ride my bike very often.)

Anything else to add, comment or specify?
Have you ever tried e-biking?*
No
Yes

Anything else to add, comment or specify?
I accept that Tuque & bicycle experiences take pictures and videos of me to promote its activities.*
I accept.
Yes, but under certain conditions (please specify).
No, I do not accept under any condition.

Anything else to add, comment or specify?

Comments, suggestions
Fourth Participant's Signature*
Fifth Participant's Name

First Name*

Last Name*

Phone*
Fifth Participant's Date of Birth*
Fifth Participant's health profile & bike experience

What is your height (cm/feet)? *
I confirm that I weigh less than the user weight limit of the bike manufacturer: 250 lbs/115 kg.*
Yes, I weigh less than 250 lbs/115 kg.
No, I weigh over than 250 lbs/115 kg.
Allergies and food restrictions?*
No
Yes

If yes, please specify :
Are you pregnant?*
No
Yes
Do you take any medication?*
No
Yes

If yes, please specify :
Do you have any physical, emotional or behavioural health problems that would directly or indirectly limit you in the activity you will be participating in? Specify, e.g. respiratory problems, heart problems, diabetes, vision problems, deafness, fear of water/heights/dogs, limitation of movement, etc.*
No
Yes

If yes, please specify :
N.B.: If you answered yes to any of the above questions, YOU MUST CONTACT AND INFORM TUQUE & BICYCLE EXPERIENCES AND THE INSTRUCTOR. After discussing this with the person in charge of the course, I accept the additional risk that could result in a possible worsening of my health condition.*
I accept.
I do not accept.
I answered NO to all questions.
I consider myself an active and healthy person.*
No
Yes

Anything else to specify?
How would you describe your overall cycling experience?*
None (I have never ridden a bike).
Beginner (I've been cycling for a long time.)
Beginner (I don't ride my bike very often and I don't feel totally comfortable riding at the moment).
Beginner (I feel comfortable riding, but I don't ride often.)
Intermediate (I ride my bike often.)
Advanced (I ride my bike very often.)

Anything else to add, comment or specify?
Have you ever tried e-biking?*
No
Yes

Anything else to add, comment or specify?
I accept that Tuque & bicycle experiences take pictures and videos of me to promote its activities.*
I accept.
Yes, but under certain conditions (please specify).
No, I do not accept under any condition.

Anything else to add, comment or specify?

Comments, suggestions
Fifth Participant's Signature*
Sixth Participant's Name

First Name*

Last Name*

Phone*
Sixth Participant's Date of Birth*
Sixth Participant's health profile & bike experience

What is your height (cm/feet)? *
I confirm that I weigh less than the user weight limit of the bike manufacturer: 250 lbs/115 kg.*
Yes, I weigh less than 250 lbs/115 kg.
No, I weigh over than 250 lbs/115 kg.
Allergies and food restrictions?*
No
Yes

If yes, please specify :
Are you pregnant?*
No
Yes
Do you take any medication?*
No
Yes

If yes, please specify :
Do you have any physical, emotional or behavioural health problems that would directly or indirectly limit you in the activity you will be participating in? Specify, e.g. respiratory problems, heart problems, diabetes, vision problems, deafness, fear of water/heights/dogs, limitation of movement, etc.*
No
Yes

If yes, please specify :
N.B.: If you answered yes to any of the above questions, YOU MUST CONTACT AND INFORM TUQUE & BICYCLE EXPERIENCES AND THE INSTRUCTOR. After discussing this with the person in charge of the course, I accept the additional risk that could result in a possible worsening of my health condition.*
I accept.
I do not accept.
I answered NO to all questions.
I consider myself an active and healthy person.*
No
Yes

Anything else to specify?
How would you describe your overall cycling experience?*
None (I have never ridden a bike).
Beginner (I've been cycling for a long time.)
Beginner (I don't ride my bike very often and I don't feel totally comfortable riding at the moment).
Beginner (I feel comfortable riding, but I don't ride often.)
Intermediate (I ride my bike often.)
Advanced (I ride my bike very often.)

Anything else to add, comment or specify?
Have you ever tried e-biking?*
No
Yes

Anything else to add, comment or specify?
I accept that Tuque & bicycle experiences take pictures and videos of me to promote its activities.*
I accept.
Yes, but under certain conditions (please specify).
No, I do not accept under any condition.

Anything else to add, comment or specify?

Comments, suggestions
Sixth Participant's Signature*
Seventh Participant's Name

First Name*

Last Name*

Phone*
Seventh Participant's Date of Birth*
Seventh Participant's health profile & bike experience

What is your height (cm/feet)? *
I confirm that I weigh less than the user weight limit of the bike manufacturer: 250 lbs/115 kg.*
Yes, I weigh less than 250 lbs/115 kg.
No, I weigh over than 250 lbs/115 kg.
Allergies and food restrictions?*
No
Yes

If yes, please specify :
Are you pregnant?*
No
Yes
Do you take any medication?*
No
Yes

If yes, please specify :
Do you have any physical, emotional or behavioural health problems that would directly or indirectly limit you in the activity you will be participating in? Specify, e.g. respiratory problems, heart problems, diabetes, vision problems, deafness, fear of water/heights/dogs, limitation of movement, etc.*
No
Yes

If yes, please specify :
N.B.: If you answered yes to any of the above questions, YOU MUST CONTACT AND INFORM TUQUE & BICYCLE EXPERIENCES AND THE INSTRUCTOR. After discussing this with the person in charge of the course, I accept the additional risk that could result in a possible worsening of my health condition.*
I accept.
I do not accept.
I answered NO to all questions.
I consider myself an active and healthy person.*
No
Yes

Anything else to specify?
How would you describe your overall cycling experience?*
None (I have never ridden a bike).
Beginner (I've been cycling for a long time.)
Beginner (I don't ride my bike very often and I don't feel totally comfortable riding at the moment).
Beginner (I feel comfortable riding, but I don't ride often.)
Intermediate (I ride my bike often.)
Advanced (I ride my bike very often.)

Anything else to add, comment or specify?
Have you ever tried e-biking?*
No
Yes

Anything else to add, comment or specify?
I accept that Tuque & bicycle experiences take pictures and videos of me to promote its activities.*
I accept.
Yes, but under certain conditions (please specify).
No, I do not accept under any condition.

Anything else to add, comment or specify?

Comments, suggestions
Seventh Participant's Signature*
Eighth Participant's Name

First Name*

Last Name*

Phone*
Eighth Participant's Date of Birth*
Eighth Participant's health profile & bike experience

What is your height (cm/feet)? *
I confirm that I weigh less than the user weight limit of the bike manufacturer: 250 lbs/115 kg.*
Yes, I weigh less than 250 lbs/115 kg.
No, I weigh over than 250 lbs/115 kg.
Allergies and food restrictions?*
No
Yes

If yes, please specify :
Are you pregnant?*
No
Yes
Do you take any medication?*
No
Yes

If yes, please specify :
Do you have any physical, emotional or behavioural health problems that would directly or indirectly limit you in the activity you will be participating in? Specify, e.g. respiratory problems, heart problems, diabetes, vision problems, deafness, fear of water/heights/dogs, limitation of movement, etc.*
No
Yes

If yes, please specify :
N.B.: If you answered yes to any of the above questions, YOU MUST CONTACT AND INFORM TUQUE & BICYCLE EXPERIENCES AND THE INSTRUCTOR. After discussing this with the person in charge of the course, I accept the additional risk that could result in a possible worsening of my health condition.*
I accept.
I do not accept.
I answered NO to all questions.
I consider myself an active and healthy person.*
No
Yes

Anything else to specify?
How would you describe your overall cycling experience?*
None (I have never ridden a bike).
Beginner (I've been cycling for a long time.)
Beginner (I don't ride my bike very often and I don't feel totally comfortable riding at the moment).
Beginner (I feel comfortable riding, but I don't ride often.)
Intermediate (I ride my bike often.)
Advanced (I ride my bike very often.)

Anything else to add, comment or specify?
Have you ever tried e-biking?*
No
Yes

Anything else to add, comment or specify?
I accept that Tuque & bicycle experiences take pictures and videos of me to promote its activities.*
I accept.
Yes, but under certain conditions (please specify).
No, I do not accept under any condition.

Anything else to add, comment or specify?

Comments, suggestions
Eighth Participant's Signature*
Ninth Participant's Name

First Name*

Last Name*

Phone*
Ninth Participant's Date of Birth*
Ninth Participant's health profile & bike experience

What is your height (cm/feet)? *
I confirm that I weigh less than the user weight limit of the bike manufacturer: 250 lbs/115 kg.*
Yes, I weigh less than 250 lbs/115 kg.
No, I weigh over than 250 lbs/115 kg.
Allergies and food restrictions?*
No
Yes

If yes, please specify :
Are you pregnant?*
No
Yes
Do you take any medication?*
No
Yes

If yes, please specify :
Do you have any physical, emotional or behavioural health problems that would directly or indirectly limit you in the activity you will be participating in? Specify, e.g. respiratory problems, heart problems, diabetes, vision problems, deafness, fear of water/heights/dogs, limitation of movement, etc.*
No
Yes

If yes, please specify :
N.B.: If you answered yes to any of the above questions, YOU MUST CONTACT AND INFORM TUQUE & BICYCLE EXPERIENCES AND THE INSTRUCTOR. After discussing this with the person in charge of the course, I accept the additional risk that could result in a possible worsening of my health condition.*
I accept.
I do not accept.
I answered NO to all questions.
I consider myself an active and healthy person.*
No
Yes

Anything else to specify?
How would you describe your overall cycling experience?*
None (I have never ridden a bike).
Beginner (I've been cycling for a long time.)
Beginner (I don't ride my bike very often and I don't feel totally comfortable riding at the moment).
Beginner (I feel comfortable riding, but I don't ride often.)
Intermediate (I ride my bike often.)
Advanced (I ride my bike very often.)

Anything else to add, comment or specify?
Have you ever tried e-biking?*
No
Yes

Anything else to add, comment or specify?
I accept that Tuque & bicycle experiences take pictures and videos of me to promote its activities.*
I accept.
Yes, but under certain conditions (please specify).
No, I do not accept under any condition.

Anything else to add, comment or specify?

Comments, suggestions
Ninth Participant's Signature*
Tenth Participant's Name

First Name*

Last Name*

Phone*
Tenth Participant's Date of Birth*
Tenth Participant's health profile & bike experience

What is your height (cm/feet)? *
I confirm that I weigh less than the user weight limit of the bike manufacturer: 250 lbs/115 kg.*
Yes, I weigh less than 250 lbs/115 kg.
No, I weigh over than 250 lbs/115 kg.
Allergies and food restrictions?*
No
Yes

If yes, please specify :
Are you pregnant?*
No
Yes
Do you take any medication?*
No
Yes

If yes, please specify :
Do you have any physical, emotional or behavioural health problems that would directly or indirectly limit you in the activity you will be participating in? Specify, e.g. respiratory problems, heart problems, diabetes, vision problems, deafness, fear of water/heights/dogs, limitation of movement, etc.*
No
Yes

If yes, please specify :
N.B.: If you answered yes to any of the above questions, YOU MUST CONTACT AND INFORM TUQUE & BICYCLE EXPERIENCES AND THE INSTRUCTOR. After discussing this with the person in charge of the course, I accept the additional risk that could result in a possible worsening of my health condition.*
I accept.
I do not accept.
I answered NO to all questions.
I consider myself an active and healthy person.*
No
Yes

Anything else to specify?
How would you describe your overall cycling experience?*
None (I have never ridden a bike).
Beginner (I've been cycling for a long time.)
Beginner (I don't ride my bike very often and I don't feel totally comfortable riding at the moment).
Beginner (I feel comfortable riding, but I don't ride often.)
Intermediate (I ride my bike often.)
Advanced (I ride my bike very often.)

Anything else to add, comment or specify?
Have you ever tried e-biking?*
No
Yes

Anything else to add, comment or specify?
I accept that Tuque & bicycle experiences take pictures and videos of me to promote its activities.*
I accept.
Yes, but under certain conditions (please specify).
No, I do not accept under any condition.

Anything else to add, comment or specify?

Comments, suggestions
Tenth Participant's Signature*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent Email Address

Email*

Confirm Email*
Check to receive our newsletter
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

Legal parents or guardians designated by a court of law must sign for all minor participants (16 years old or younger) and must acknowledge that they and the minor will act in accordance with the conditions of this document as indicated below.



By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent Name

First Name*

Last Name*

Phone*
Parent Date of Birth*
Parent health profile & bike experience

What is your height (cm/feet)? *
I confirm that I weigh less than the user weight limit of the bike manufacturer: 250 lbs/115 kg.*
Yes, I weigh less than 250 lbs/115 kg.
No, I weigh over than 250 lbs/115 kg.
Allergies and food restrictions?*
No
Yes

If yes, please specify :
Are you pregnant?*
No
Yes
Do you take any medication?*
No
Yes

If yes, please specify :
Do you have any physical, emotional or behavioural health problems that would directly or indirectly limit you in the activity you will be participating in? Specify, e.g. respiratory problems, heart problems, diabetes, vision problems, deafness, fear of water/heights/dogs, limitation of movement, etc.*
No
Yes

If yes, please specify :
N.B.: If you answered yes to any of the above questions, YOU MUST CONTACT AND INFORM TUQUE & BICYCLE EXPERIENCES AND THE INSTRUCTOR. After discussing this with the person in charge of the course, I accept the additional risk that could result in a possible worsening of my health condition.*
I accept.
I do not accept.
I answered NO to all questions.
I consider myself an active and healthy person.*
No
Yes

Anything else to specify?
How would you describe your overall cycling experience?*
None (I have never ridden a bike).
Beginner (I've been cycling for a long time.)
Beginner (I don't ride my bike very often and I don't feel totally comfortable riding at the moment).
Beginner (I feel comfortable riding, but I don't ride often.)
Intermediate (I ride my bike often.)
Advanced (I ride my bike very often.)

Anything else to add, comment or specify?
Have you ever tried e-biking?*
No
Yes

Anything else to add, comment or specify?
I accept that Tuque & bicycle experiences take pictures and videos of me to promote its activities.*
I accept.
Yes, but under certain conditions (please specify).
No, I do not accept under any condition.

Anything else to add, comment or specify?

Comments, suggestions
Parent Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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