Michael Carpenter

Electric Push Bike Rider Competency Form

Use this Template

Print as PDF

Use this Template

Title Page

Site conducted
Conducted on
Prepared by
Location
Shop Name
Team Member

Untitled Page

Road positioning
Awareness of road rules
Use of hand signals
Braking
Awareness of other road users/ pedestrians
Posture and balance
Wearing PPE correctly
Corrective Actions - if any
Completed Dominos Training - Path to Excellence
I understand the max km speed is 25 kms & power 1 is to be used, any fines are the drivers responsibility
Downloaded iAuditor & shown how to complete ebike inspection
Sanitise Helmet process understood
Shown how to remove an unsafe Ebike out of service - tag out system
How many deliveries was he shadowed on
Discussed mobile phone use, do not use while riding if you need to check your phone for GPS or make a call, stop at a safe place
Is the Team Member Permitted to Ride an Electric Bike on their own?
Manager Signature
Employee Signature

Michael Carpenter

Electric Push Bike Rider Competency Form

Use this Template

Print as PDF

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.