National Bike to School Day May 4 th, 2016 Registration Individual Participant

Transcription

1 National Bike to School Day May 4 th, 2016 Registration Individual Participant (Due April 15 th, 2016) Please read the following information with your son/daughter. Make choices where applicable. When the entire document is completed, please print and sign the document. Submit the form to West Middle School on or before Friday, April 15 th, Registration Fee: Payment in the amount of $15 can be made out to RCS. In the memo write NBTS Registration. Final payment is due Friday, April 15 th, Choose a t-shirt size. Please circle one. (Additional Shirts $8.00 add money to payment) YL (12 14) Adult S Adult M Adult L Adult XL 3. Preferred Prizes List Rank the order of your prize preferences from the list below: 1 st choice 2 nd Choice 3 rd Choice a. Millenium Falcon Picture (Grand Prize) b. Star Wars Posters (5 designs) c. Miniature Stuffed Animals Yoda, Darth Vadar, C3PO, & R2D2 d. Skeleton Cycling Jersey e. Star Wars Ornaments C3PO and Kylo Ren f. Star Wars Molds Death Star, R2D2, Bobba Fett, Darth Vadar, and Storm Troopers g. Star Wars T-Shirts - R2D2, and Darth Vadar (Adult Small, Med, Large and X-Large) h. Star Wars Darth Vadar Bag 4. Ride with a Parent or Friend I will not ride my bike to and from school alone. I will be riding my bike with (first and last name of parent or friend). (student initials) (parent initials)

2 5. Safe Crossings Map I have studied the Map (see last page) with safe cycling paths and crossing areas marked. I will review my route with my parents. The route I will be taking is: (example: I will exit my neighborhood on Brewster Rd. Head south on Brewster Rd, cross Dutton Rd on cross walk, proceed on Brewster Rd South to Walton Road. I will safely cross Walton and I will turn left and take the bike path down to Old Perch Rd where I will turn right and proceed to the school). (student initials) 6. Emergency Contact Information: In the event that an emergency arises on Wednesday, May 4 th (or rain date May 6 th ), the school may contact (name) at (phone number). 7. Bike Safety Guidelines. I have read the Bike Safety Brochure (found near the end of this document) with my son/daughter. I will follow the safe riding practices listed in bold print within this brochure as I travel to and from school during National Bike to School Day on May 4 th (or the rain date on May 6 th ). (student initials) (parent initials). 8. I will listen to all crossing guards and Bike to School volunteers as I safely travel to and from school. (student initials) (parent initials) 9. I will wear a helmet during my ride to and from school. It is important that students wear properly fitted helmets to prevent head injuries. Research shows that bicycle helmets have been shown to reduce the risk of head injury by as much as 85 percent and the risk of brain injury by as much as 88 percent. Children ages 10 to 14, especially males, have the highest death rate from bicycle-related head injury of all ages. (Provided by Safe Kids of America) In the event that I arrive at the meeting area without a helmet, I will be asked to call my parent and have a helmet dropped off before I can ride my bike to school. The group will not wait and I will need to ride in with the parent volunteer. (student initials) (parent initials)

3 I agree to the conditions stated above and will be participating in the National Bike to School Event at West Middle School on Wednesday, May 4 th. Student Name Grade Address Phone Number Homeroom Teacher Student Signature Parent Name Parent Signature

4 Bike Safety Brochure Before Your Ride 1. Helmets are vital! Always wear a helmet and make sure it s fastened correctly. Helmets can reduce head injuries by up to 85 percent. (See our fitting guide) 2. Make yourself visible! Wear bright clothing. 3. Tuck away shoelaces or other strings or cords so they don t dangle and get caught in the moving parts of your bike. 4. Wear reflectors on your bike, helmet and clothing to increase visibility when cycling in the morning or at dusk. See the diagram below. 5. At dusk and dawn, use a blinking red light on the back of your bike and a bike light on the front of your bike when visibility is low. Make yourself visible to cars. 6. Keep your bike happy and healthy. Give bikes regular tune-ups. It s just as important for a bike to be well maintained as a car. 7. Never wear headphones. You need to listen to what is happening around you. Stay alert! 8. Be prepared for mechanical emergencies with tools and know-how. Learn how to change your own tire. 9. Control your bike by practicing bike handling skills. 10. Add water bottle cages to your bike to keep water easily accessible during your ride. 11. Add a bell or horn to your bike that is in good working order. During Your Ride 1. Be Safe! Ride in safe places, such as in parks, on bike trails, and on roads with little traffic. Always ride with a friend. 2. Ride predictably! Ride straight! Don t weave in or out of traffic or swerve from side to side.

5 3. Ride your bike on bike paths or with the direction of road traffic. Be visible at all times. 4. Ride single file and use both hands for control and braking. 5. Cyclists must yield to pedestrians and should pass on the left. Call On your left or ring your bell when passing walkers or other cyclists. 6. Watch for obstacles such as potholes, glass, or other items that could be in your path and could cause you to lose control of your bike or puncture a tire. 7. Obey Traffic Laws! Ride only on the right hand side of the road. Stop behind the cross walk and at all stop signs and red lights. Use hand signals before turning. 8. Crossing Roads. Look both ways before crossing an intersection. Whenever possible, cross the road at crosswalks. Drivers expect to see bicyclists and pedestrians crossing intersections in these areas. Remember to always walk bikes across busy intersections. 9. Ride defensively! Continuously scan for traffic and signal lane changes and turns. Look for cars that are pulling out into traffic. Remember that they may not be able to see you. Always be on the lookout for cars backing up or for the sudden opening of auto doors. 10. When riding your bike past a parked car, allow 4 feet between your bike and the car to avoid being hit by an opened door. 11. One person to a bike. Don t offer a ride to another person, injuries will result. After Your Ride 1. Keep your bike safe. Lock up or keep your bike in a safe place. During our event a secure location will be provided. 2. Park your bike properly. Don t lie your bike down on the ground. Use bike racks when available. Bike racks will be provided for our event on Wednesday, May 4 th (or May 6 th ) 2016.

6 Adams Rd Crooks Rd Old Perch Livernois Brewster Livernois Dutton 1 Tienken 2 Walton Blvd 3 4 W. Avon = Numbered Meeting Areas