East Sussex Pedal Power Bike Scheme Registration


Welcome to the East Sussex Pedal Power Bike Scheme. 

The purpose of the scheme is to encourage more people to take up cycling by offering them the opportunity to try a bike and associated equipment to see how cycling can work for them. Priority is given to those who will be using the bike to get to work, training or education. 

The scheme is to open to anyone over 16 years, who lives witihin the East Sussex County Council area. 

If eligible, you will be entitled to rent a bike, lock and safety equipment.

At the end of the loan you will be asked to complete and on-line survey about how you have used the bike to support University of Brighton’s research associated with this project, but otherwise the bike is yours to use as you want. You can also access cycle training during the loan to improve your competency and confidence. 

Once your registration is complete you will be contacted by an advisor within a few days to confirm your application with you.

Person data collected as part of the registration form will be used to assess your application and to communicate to you by phone or email regarding the scheme. Anonymised data from this form maybe shared with East Sussex County Council and the University of Brighton for asessing scheme diversity and travel behaviours. By completing this form you consent to your data being used in this way. 

Please answer the questions below to register for the scheme. Should you have any issues completing the form then please email info@activecyclingprojects.com.
 
 
 
 

1. Registration form

 

1. What is your name? *

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2. Please complete your contact details.  *

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3. Are you male or female? *

 

4. What is your age? Please note that you must be over 16 to be loaned a bike. If under 18 a parent or guardian will need to sign and provide financial guarantees. *

 

5. What is your approximate height? *

 

6. What is your approximate weight? *

 

7. Please select the type of bike you would like to try. All our bikes are suitable for riding on roads, through parks and on firmed tracks. All bikes are fitted with mudguards, rear luggage rack, and are equipped with a lock. Images shown on the website are to provide an indication of style of bike, the actual bike loaned may differ from the image. *

 

8. Was this scheme recommended to you, or were you referred to us the by an agency or organisation? *

 

9. What best describes your level of cycling competence? *

 

10. Where will the bike be stored at home? *

 

11. If taking the bike to work where will it be stored?

 

12. What are the main reason/s for loaning a bike? Please tick all that apply. *

 

13. In a recent typical week, how many individual trips did you make by these means of transport? A trip refers to a single one way journey. (if none, please write 0). *

Trips 5 miles and under to get placesTrips over 5 miles to get placesLeisure trips (recreational or solely for exercise)
Bicycle
Walking
Bus
Train
Car, alone
Car, with others
Other
 

14. In the past week, on how many days have you done a total of 30 minutes or more of physical activity, which was enough to raise your breathing rate?

 

15. Which of the following best describes your ethnic background? *

 

16. What is your religion? *

 

17. Do you have any long standing illness (ie. more than 12 months and likely to continue) or do you have a disability which affects or limits your day to day activities? *

 

18. How did you hear about the scheme? *

 

19. Occasionally we will be looking for people take part in a case study for this scheme. This may include being interviewed, having your photo taken or taking part in a video. On this basis would you be willing to take part in a case study? *

 

20. Data Privacy Statement.

By completing this form, you agree to your information being used for the evaluation of the East Sussex Pedal Power Project.

Your information will be securely held by Active Cycling Projects Ltd in accordance with the Data Protection Act 1998.

All personal information collected will be stored securely and will not e shared with any other organisations or individuals outside of East Sussex County Council's Access Fund Programme unless required by law. Anonymous data may be included in project reports, which will be shared with project partners, East Sussex County Council, the Department for Transport and others as well as used to support further local and national funding bids.

In accordance with the GDPR regulations, if you do not wish your personal data to be used in this way then please do not complete your registration for this scheme. Your personal data will not have been saved at this point. 

I have read and understood the above statement. *