Safety Town Registration
Safety Town helps prevent childhood accidents by teaching pre-school children safety principles. We use a miniature city and classroom settings (with a certified teacher and a police officer) to teach children many aspects of safety: traffic, classroom, school bus, home, strangers, medicines, and more. We are registered, accredited and certified by the National Safety Town Center.
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Email *
Student Name: Last name, First name (example Mouse, Mickey) *
Student Date of Birth ( mm/dd/yyyy) *
Student Age (at the start of class) *
Parent/Guardian Name *
Parent/Guardian Relation to student *
Parent/Guardian Phone Number *
Child's T-Shirt Size *
Student Address (Example: 3160 Oakwood, Melvindale 48122) *
Student Allergies / Dietary Concerns (If no concerns, enter NONE) *
Name of person authorized to pick student up. (changes to this must be handled personally with Ms. Mary for the safety of the student) *
A copy of your responses will be emailed to the address you provided.
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