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Buckle Up Bowl Registration 2020
Compete against other Lorain County high schools to have the highest seat belt rate in the 2020 Buckle Up Bowl. All interventions are student led - we'll supply the materials and you supply the content!

This registration form is due by Friday, February 21, 2020.

Winning Categories:
-Most creative campaign
-Most improved seat belt usage
-Best overall seat belt usage in Lorain County*

*The winning school for best overall seat belt usage receives a cash prize for classroom enhancements generously donated by the Dominic Zunis Memorial Foundation. https://www.domzunisfoundation.org/

2020 Buckle Up Bowl timeline

February 21: registration due
March 30-April 3: unannounced visual seat belt surveys
April 6-May 1: intervention period (You will receive 2 google forms to complete/upload photos and share what you have done)
May 4-8: unannounced visual seat belt surveys
Week of May 11: Winners announcement
Week of May 18 (TENTATIVE): Buckle Up Bowl student showcase

Do you need help completing the registration or have any questions? Please email aaccordino@LorainCountyHealth.com or call 440-284-3218. You will receive an email confirming your application has been submitted.

The Buckle Up Bowl is coordinated by the Safe Communities Coalition conducted through Lorain County Public Health. "Saved by the Belt" image from Florida Department of Highway Safety and Motor Vehicles.
Email address *
High School Name *
Your answer
Name of the primary contact for the Buckle Up Bowl *
Your answer
Primary contact email and phone number *
Your answer
Please list any student group/clubs that will be involved.
Your answer
High School Principal name *
Your answer
High School Principal email *
Your answer
School Resource Officer (if applicable)
Your answer
Typical school day start time *
Your answer
Number of entrances to school campus *
Your answer
Best days of the week for an unannounced visual seat belt survey (March 30-April 3 & May 4-8). Please check all that apply and leave a comment if needed.
Are you interested in scheduling a Buckle Up Bowl planning meeting to discuss options and generate ideas with the Safe Communities Coalition?
In exchange for your dedication to traffic safety and participation in the 2020 Buckle Up Bowl, the Safe Communities Coalition would like to provide a customized paper material for your school district with a buckle up message. What materials are you interested in receiving? *
Required
How many paper materials do you need printed? *
Your answer
When would you like to receive the paper materials? Is there a color or theme you'd like to follow? Please describe the material. *
Your answer
Please check interventions you are interested in that Safe Communities Coalition can provide for you
Please check interventions that your school and students might be interested in creating and/or coordinating
A copy of your responses will be emailed to the address you provided.
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