Lewisham Bike Loan Scheme Registration

Welcome to the Lewisham Bike Loan Scheme.
 
The scheme is open to you, if you live, work or study in the Borough and you are aged 16
years or over.
 
You will be entitled to borrow a bike for 4 weeks free of charge, we only require you to
pay £10 for membership to the London Cycling Campaign which will provide you
with many benefits including liability insurance cover whilst cycling.
 
During the loan you will be expected to complete a weekly on­line survey about how you
have used the bike, but otherwise the bike is yours for 4 weeks to use as you
want.
 
Once your registration is complete you will be contacted witihn a week by an advisor to confirm your place at  an induction session where you can collect a bike and accessories. At peak periods this may take a little longer.
 
The information submitted on this form will be used by the London Cycling Campaign
and its operating partners for the purpose of assessing the type and size of
bike suitable for you, and for communicating with you regarding the loan
scheme.
 
Please answer the questions below to register your interest in the scheme.
 

1. 1. Please indicate your preference of when you would like to attend an induction where you will collect a bike for 4 weeks use. Sessions are held fortnightly on a Thursday and you can attend anytime between 2pm and 7pm. Your place will be confirmed within in a few days or you will be offered alternative dates if the session is already full. *

 

2. What is your name? *

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3. Please complete your contact details *

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4. Are you male or female? *

 

5. What is your age? Please note that you must be over 16 to be loaned a bike. *

 

6. What is your approximate height? *

 

7. What is your approximate weight? *

 

8. Please select the type of bike you would like to try. All 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. Pictures below are to provide an indication of style of bike, the actual bike loaned may differ from the image. *

 

9. How would you describe your current level of cycling experience? *

 

10. Do you require a child­seat to be fitted to the bike? Child­seats are suitable for carrying a child between 1 and 4 years and not over 22kgs, but cannot be fitted to folding bikes. *

 

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

 

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

 

13. Will you be leaving the bike at a station? *

 

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

 

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. Was this cycle loan scheme recommended by someone who had previously been loaned a bike through the scheme? *

 

19. How did you hear about the scheme? *

 

20. Which of the following would you be interested in? *

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Free one to one cycle training
Bike Maintenance Classes
Information on cycling, walking, free bike checks and things to do in the Borough
 

21. Would you like to receive the free Lewisham Life enewsletter which contains details of things to do, community news, special offers and competitions, and also receive information on cycling related events and information from Lewisham Council? *

 

22. 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? *