This form is only for people that have paid for a place on an MB Swindon training course. If you have not yet paid for a place, please visit the training page for details of the courses on offer.

    Course (required)

    First Name (required)

    Surname (required)

    Gender (required)

    Address (required)

    Phone (required)

    Email (required)

    Age (required)

    Emergency Contact - Name (required)

    Emergency Contact - Relationship (required)

    Emergency Contact - Phone (required)

    Make/model of mountain bike you intend to use on the course (if known)

    Type of mountain bike you intend to use on the course (if known)

    Any medical conditions your trainer should be aware of? (required, but just write no if there aren't any)

    Any additional info you'd like to make your trainer aware of?