BikeEd Hawai‘iPermission Slip
All 4th grade students will participate in the Hawai‘i Bicycling League’s BikeEd Hawai‘i program on the schoolgrounds/neighboring park, including safety instructions on and off the bicycle. Beginner bicyclists will receive instruction
on riding based on their skill level. Please check one of the two boxes below, then read, sign, and return the form.
Students who DO NOT return this form, or provide a form without a completed checkbox below,
will ONLY receive instruction on school grounds or nearby parks, and will NOT be allowed to ride on public streets.

I APPROVE of my child riding a bicycle off-campus on public streets under HBL's BikeEd Hawai‘i supervision.
I DECLINE to have my child ride a bicycle at all, even on school grounds.
RISK:

I fully assume the risk of serious injuries that may possibly occur. My child must behave and listen to theinstructors to prevent harm to him/herself and others.

HEALTH:My child is in good physical health and all sight or hearing-impairments have been reported to the school.
My child has no physical or medical condition that prevents him/her from safely participating.

MEDIA:

BikeEd Hawai‘i photos, videos, posters, and thank you letters are the property of Hawai‘i Bicycling League
and may be publicly displayed to promote the program. I provide HBL permission for free use of my child’s
photographs from participating in the BikeEd Hawai‘i program in outreach and program promotion.

WAIVER:I, the minor's parent and/or legal guardian, understand the nature of bicycling activities, the minor'sexperience and capabilities, and believe the minor to be qualified, in good health, and in proper physicalcondition to participate in such activity. I hereby release, discharge, covenant not to sue, and agree toindemnify and save and hold harmless Hawai‘i Bicycling League, The City & County of Honolulu, and The
State of Hawai‘i from all liability, claims, demands, losses, or damages on the minor's account caused oralleged to be caused in whole or in part by the "releasees", including rescue operations and further agree
that if, despite this release, I, the minor, or anyone on the minor's behalf makes a claim against any of thereleasees named above, I will indemnify, save, and hold harmless each of the releasees from any litigation
expenses, attorney fees, loss liability, damage, or cost any may incur as the result of any such claim.

Child's Name______________________________

BikeEd Hawai‘i Merchandise Order Form (Optional)___ $15 T-shirt Youth: S M L Adult: S M L XL

School________________Teacher_____________
Parent/Guardian Name______________________⃞ I would like to volunteer to help with the BikeEd Hawaii *Signature___________________Date__________
Email_______________________________________ $15 HelmetLarge(58-62cm)

Extra Large(59-63cm)___ $28 T-Shirt / Helmet Combo (Save $2.00)(circle sizes above)$____ Additional Donation to BikeEd Hawai‘i*Make checks payable to Hawai‘i Bicycling League**$25 fee charged for returned checks.

* Volunteers help the BikeEd Hawai‘i instructors teach students to ride bicycles. Please let your child’s teacher know when you can volunteer.
You agree to waive all rights and claims for damages against HBL, its staff, sponsors, the City & County of Honolulu and the State of Hawai‘i.
(7/23)

BikeEd Hawai‘i
Parent Information Sheet (Parent Copy)
What is BikeEd Hawai‘i?

What will my child learn?

A program of Hawai‘i Bicycling League, BikeEd
Hawai‘i was established in 1989 and teaches thefundamentals of bicycle safety. BikeEd Hawai‘ireaches over 8,000 students on O‘ahu annually.
The program helps meet school benchmarks in
Health and Physical Education and includes 3days of on-campus instruction and 2 days ofoff-campus riding. The program is primarily
funded by the City & County of Honolulu Dept. ofTransportation Services. BikeEd Hawai‘i is taught
by HBL certified instructors but we welcome
parents to help volunteer!
For more information, visit HBL.org/BikeEd orcontact us by email BikeEd@HBL.org

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Basic bicycle safety principles in a fun format
that enables keiki to develop a lifelong
healthy lifestyle.
The “6-point bicycle safety check” (handlebar,
seat, chain, pedals, brakes, tires).
The importance of properly wearing a helmet.
Ride on the right side of the road and stay on
checkpoint (3ft. from the curb or parkedvehicle).
Correct procedures at stop signs,
intersections, turns, and driveway exits.
How riding a bicycle safely is fun!

What to bring to class:●●●

Closed toe shoes (No Slippers or Crocs)
Shorts or rollable pants
Water bottle● Helmet (if needed, we have helmets to borrow*,or helmets available for purchase)*Due to reuse of BikeEd helmets, all students must receive licechecks by school nurses. Students who have lice will be required
to bring their own helmet, purchase one from BikeEd Hawai‘i, orwill only be able to participate in the first day of instruction.

HBL and BikeEd Hawai‘i are supporters of
The Safe Routes to School Initiative.
Learn more at HBL.org/BikeEd

Hawai‘i Bicycling League
Founded in 1975 with the mission of enabling more people to ride bicycles
for health, recreation, and transportation through advocacy, education, andevents. We are a 501(c)3 non-profit organization dedicated to makingHawai‘i a better place to bike, walk, roll, and live.

Visit HBL.org to learn more about our work, free cycling workshops,and upcoming events, such as the family-friendly Aloha Fun Ride!