Thank you for participating in our child safety survey! Your response will help guide our current and future programs that support keeping the children in our community healthy and safe. If you enter your contact information in question 11 you will be entered to win a $25 Amazon gift card. Winners will be called after the survey closes.

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* 1. Have you heard of Safe Kids Larimer County?

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* 2. What is your zip code?

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* 3. How many children live with you?

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* 4. How old are the child(ren) that live with you? Please choose all that apply.

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* 5. Which of the following safety topics are you most confident in your knowledge of? Choose all that apply.

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* 6. Please rank the following safety topics in order of importance to you and your family.

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* 7. Which of the following safety topics are you interested in learning more about? Choose all that apply.

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* 8. Which of the following sources do you use when you want to know more about keeping your child(ren) safe? Check all that apply.

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* 9. Would you be interested in a quarterly e-newsletter on child safety information?

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* 10. Is there any additional information, questions or concerns that you would like us to know about your interest in and commitment to preventing childhood injuries?

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* 11. Please enter your contact information if you would like to be entered into the drawing. Please note your information will only be used to contact you if you are one of the winners or answered 'yes' to a quarterly newsletter in question 9. 

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