Walk to School Day LA 2017: Registration Form
Your School's Event Date
MM
/
DD
/
YYYY
School Start Bell Time
Time
:
School Name
Please write out the full/formal name. E.g. Shenandoah Street Elementary School
Your answer
Principal's Name
Your answer
Expected Number of Students Participating
Your answer
Event Organizers Name
Your answer
Event Organizer's Phone Number
Your answer
Event Organizer's Email
Your answer
Preferred Means of Communication
Main Reason for Hosting the Event
Upon completion of this registration, have you already received a walk to school banner?
In general, about how safe would you say children feel walking to or from your school?
Very Safe
Not Safe
The following are safety concerns for students walking to your school (check all that apply)
In addition to Walk to School Day, does your school host other walking and bicycling events, activities or safety education (CHECK ONE OR MORE)
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