Parent Survey

This helmet was provided by the Safe Mobility Project. The Safe Mobility Project is a collaboration between Akron Children’s Hospital and the Goodyear Foundation. It enables the hospital and community partner organizations to expand child safety programs focusing on child passenger seats, bike helmets, and teen drivers.

Be smart, wear your helmet every time you ride and protect your brain!

Complete the survey for a chance to win the prize, a gift card, to purchase a new bike. By completing this survey you consent to Akron Children's Hospital using you or your child's photograph on social media. (A photo release will be used at the time of the picture.)

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* 1. Parent or Guardian Name

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* 2. Phone Number

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* 3. Email

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* 4. Zip Code

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* 5. Child's First and Last Name

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* 6. Child's Age

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* 7. What safety town or event did your child receive their helmet at?

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* 8. When should your child wear a helmet?

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* 9. Where should your child’s helmet straps be?

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* 10. How many children per year get sent to the hospital nationally because of not wearing their helmet?

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* 11. TRUE or FALSE: Helmets should rest 2 finger lengths above your eyebrows for best protection.

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* 12. TRUE or FALSE: It is safe to wear a helmet after it has been cracked from a previous crash.

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