Spring Event Registration

Congratulations! By choosing to hold a Spring Walk to School Day event in your community, you’re taking major action to keep the kids in your area healthy and fit. Please take a moment to fill in the information below so we know a little about your event (fields in red are required). Once you’ve registered your event, you’ll have access to professionally designed promotional materials to help you get the word out about your event.

Registration
Name
School or Community Group
Address
City
Phone Number	### ###-####
E-mail
Event Time
Event Location
Number of Students Involved

Is this part of an existing Safe Routes Program, or is this your first event?

Event Program

Tell us what you're planning (check all that apply)
	Walking School Bus	In-Class Activities
	Park and Walk Stops	Safe Routes Jeopardy
	Walk-A-Thon	Incentives/Giveaways
	Recess Activities	Parent Presentations
	Walking to/from School	Health/Wellness Fair
	Biking/Walking Safety Information	Walking/Biking Safety Presentations
Other

Media Information
Would you like Safe Routes Nebraska to help promote your event to local media?	Yes No

Your local newspaper
Your radio stations
Your TV stations
Contact phone number day of event	### ###-####