2020 Provincial High Performance Team Application

Athlete Name *

First

Last

Athlete Email *

Athlete Phone Number

Athlete Age

Street Address

City, Province and Postal Code

Discipline of Focus

Let us know what type of cycling appeals to you most (you can pick more than one).

Years of Experience in Competitive Cycling (any discipline)

Career Highlights

Share a little bit about some recent finished or events that sparked your interest in pursuing competitive cycling at a provincial level.

2020 Season Goal

Three to Five Year Goal

Are You Currently on a Training Plan?

Yes
No

Do You Currently Have a Coach?

Yes
No

If you have a coach, how long have you been working with them?

How many hours can you commit to training? (Both in season and over the winter)

Do you participate in any other sports?

Yes
No

Will cycling be your primary sport this season?

Yes
No

Are you willing to participate in provincial team training sessions, program camps and race projects?

Yes
No

Are you willing to work with Bicycle Nova Scotia's Provincial Team Coach?

Yes
No

By participating in the Provincial High Performance Team, you acknowledge that you will adhere to Cycling Canada's Race Clean anti-doping commitment. This include participation in anti-doping training and testing, if required. Please check the box below to acknowledge this understanding.

I understand that I need to adhere to Race Clean anti-doping commitments.

By participating in the Provincial High Performance Team, you acknowledge that you will agree to uphold Bicycle Nova Scotia core values and demonstrate leadership, sportsmanship and ethical behaviour while representing the organization. Please check the box below to acknowledge this understanding.

I understand and agree to upholding Bicycle Nova Scotia's values.

Parent Name *

First

Last

Parents must endorse this form if the Athlete is under 18 years of age.