GRASS ROOTS RIDER PROGRAMME

Ride. Represent. Get Involved.

The Extreme Culture® Grass Roots Rider Programme, supported by Cynon Valley Cycles, is for riders who want to become part of something bigger than simply receiving discounted products.

We're looking for riders who are passionate about riding, their local community and helping grow the cycling and action-sports scene.

If that's you, we'd love to hear from you.

Please complete the application form below (DOWNLOAD LINK BELOW) and tell us about yourself, your riding and what you could bring to the programme.

DOWNLOAD PDF FILE HERE: https://mega.nz/file/FgsHnD5a#lkSQKgyzzEhwUeB9E0RWhJ3K6JVct1GDXpMVIRY9v90

1. RIDER DETAILS

Full Name*
[Text field]

Riding / Social Media Name (if applicable)
[Text field]

Date of Birth*
[Date field]

Age*
[Number field]

Address*
[Address field]

Postcode*
[Text field]

Telephone Number*
[Phone field]

Email Address*
[Email field]

2. RIDING INFORMATION

What type of riding do you participate in?

Select all that apply.

☐ MTB
☐ BMX
☐ Motocross
☐ Enduro
☐ Downhill
☐ Dirt Jump
☐ Gravel
☐ Road
☐ E-Bike
☐ Skate
☐ Other: [Text field]

How many years have you been riding?*
[Number field]

How often do you ride?

☐ Daily
☐ Several times a week
☐ Weekly
☐ A few times a month
☐ Other: [Text field]

Where do you mainly ride?*
[Large text field]

3. COMPETITION & EXPERIENCE

Do you currently compete?*

○ Yes
○ No

If yes, what events / series do you compete in?
[Large text field]

Category / Class
[Text field]

Recent results or achievements
[Large text field]

Are you planning to compete in the next 12 months?*

○ Yes
○ No
○ Maybe

If yes, please tell us what you are planning:
[Large text field]

4. YOUR RIDING GOALS

What would you like to achieve through riding over the next 12 months?*

[Large text field]

What areas would you like help or advice with?

Select all that apply.

☐ Bike setup
☐ Maintenance / mechanical knowledge
☐ Training
☐ Fitness
☐ Racing advice
☐ Competition preparation
☐ Content creation
☐ Photography / video
☐ Social media
☐ Product / equipment advice
☐ Local riding opportunities
☐ Other: [Text field]

5. WHY DO YOU WANT TO JOIN?

Tell us why you would like to become part of the Grass Roots Rider Programme:*

[Large text field]

What do you think you could bring to the team / community?*

[Large text field]

What does supporting your local independent bike shop mean to you?*

[Large text field]

6. COMMUNITY & TEAM INVOLVEMENT

We are looking for riders who want to be part of something bigger than simply receiving discounted products.

Would you be interested in helping with:

Select all that apply.

☐ Shop events
☐ Group rides
☐ Local riding sessions
☐ Demo days
☐ Competitions / race events
☐ Photography / video
☐ Social media content
☐ Helping younger / newer riders
☐ Product testing / feedback
☐ Community projects
☐ Representing the shop at events

Anything else you would like to contribute?

[Large text field]

7. SOCIAL MEDIA & CONTENT

Instagram
[Text field]

Facebook
[Text field]

TikTok
[Text field]

YouTube
[Text field]

Other
[Text field]

Are you comfortable creating occasional riding content featuring the programme / shop?*

○ Yes
○ No
○ Maybe

8. BIKE & EQUIPMENT

Current bike / bikes*
[Large text field]

Bike size
[Text field]

Helmet size
[Text field]

Glove size
[Text field]

Jersey / clothing size
[Text field]

Anything about your current setup that you would like advice or support with?

[Large text field]

9. EMERGENCY CONTACT

Emergency Contact Name*
[Text field]

Relationship to Rider*
[Text field]

Telephone Number*
[Phone field]

Email (optional)
[Email field]

10. PARENT / GUARDIAN CONSENT

For riders under 18 only

A parent or legal guardian must complete the consent section below for riders under 18.

I confirm that I am the parent/legal guardian of the rider named on this form and give permission for them to participate in the Extreme Culture® / Cynon Valley Cycles Grass Roots Rider Programme.

Parent / Guardian Name*
[Text field]

Telephone*
[Phone field]

Signature*
[Signature field]

Date*
[Date field]

☐ I confirm that I am the parent/legal guardian of the rider named above and give permission for them to participate in the programme.*

11. RIDER AGREEMENT

By submitting this form, I understand that the Grass Roots Rider Programme is a community-based programme and does not automatically guarantee sponsorship, free products, financial support or employment.

I agree to represent the programme, the shop and associated brands respectfully and responsibly when participating in events, riding activities and online, for a period of 12 months from the date agreed.

I understand that any discounts, equipment, opportunities or other benefits offered through the programme may be subject to individual agreement and availability.

I agree to follow reasonable safety requirements and any rules relating to organised rides, events or activities.

Rider Name*
[Text field]

Rider Signature*
[Signature field]

Date*
[Date field]

☐ I have read and agree to the Rider Agreement above.*

12. PRIVACY & COMMUNICATION

We will use the information provided on this form to assess your interest in the programme and to contact you regarding programme activities and opportunities.

Can we contact you regarding the Grass Roots Rider Programme?*

○ Yes
○ No

Preferred method of contact

☐ Email
☐ Telephone
☐ Text / WhatsApp

Would you like to receive occasional information about shop events, rider activities and programme opportunities?*

○ Yes
○ No

READY TO RIDE WITH US?

Thank you for your interest in the Extreme Culture® Grass Roots Rider Programme.

We're interested in riders who are passionate about what they do, want to get involved with their local riding community and are keen to represent the programme and the shop in a positive and responsible way.

Complete your application above and we'll review your details.

[ SUBMIT GRASS ROOTS RIDER APPLICATION ]

What happens next?

Your application will be reviewed by the team. If selected, we'll be in touch to discuss the programme and any opportunities, discounts, equipment or support that may be available.

Please remember that submitting an application does not automatically guarantee sponsorship, free products, financial support or employment.

Extreme Culture® / Cynon Valley Cycles