2018 Bike Helmet Application

Thank you for your interest in submitting an application for bike helmets!

The Ohio AAP is excited to once again provide bike helmets to organizations participating in Bike Helmet Safety Awareness Month – May 2018. The Ohio AAP will provide helmets based upon the available funding, number of applications, and need of each community/organization. Completion of an application is not a guarantee to receive helmets. Notification of bike helmet awards will be made using the email in the application no later than March 12, 2018. To receive full consideration, a complete application must be submitted through this form no later than March 2, 2018.

Applicant Information

Types of events include Bike Rodeos, Helmet Giveaways, etc.
(If Applicable)
(If Applicable)

Program Information

XS estimated for ages 3 - 6
S/M estimated for ages 6 - 11
L/XL estimated for ages 11 years and older
(Quantities/Sizes not guaranteed - this field is designed to automatically populate. If it does not populate in your internet browser, simply ignore and we will populate on our end)

Organization Bike Helmet/Injury Prevention Information

Terms of Grant: By typing your initials on each item, and typing your full name at the end of the application, you agree to complete these terms in their entirety in return for receipt of helmets. Failure to complete any of the required items may lead to disqualification for helmets in future years.

Link will be sent to the indicated contact email.
(Inability to pick up helmets during distribution day WILL NOT automatically disqualify applicants from receiving helmets.)