Name of service: *

Director or Manager’s name: *

Meets Criteria: *

• I have read the Stride and Ride criteria and our service meets all criteria in practice

Tell us how: *

Tell us how you include road safety education and/or active transport at your service (100 – 200 words minimum)

Physical Fitness Policy: *

I have attached our service’s Physical Activity policy which meets Stride and Ride criteria.

Policy Approval: *

• Our Director/Manager has approved and signed our service’s Physical Activity policy which meets Stride and Ride criteria

Application Approval: *

• I have the Director/Manager’s support in applying for this incentive

Photos (optional):

Photo 1:  

Photo 2:  

Photo 3:  

I confirm MWEW has permission to share these photos: *

Check one box only

• Yes
• not applicable, no photos uploaded

My Name: *

Service email address: *

Share Photos: *

• If successful, we agree to share photos of the balance bike and helmet sets in use (with media permissions for Move Well Eat Well to share on social media, our website, and in newsletters)