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Event/Resource Request Form

Safe Kids Wake County is a group of community and organizational volunteers who are dedicated to providing childhood injury prevention education and resources to local communities.  In order to best serve the needs of the community and provide adequate resources, we ask that you complete this form. The Executive Committee will evaluate your request. We require a minimum of 60 days notice to adequately plan for utilization of resources.  Please be advised, active membership (attendance at 3 meetings, volunteer at 1 event) is encouraged to request event support.  Thank you for your interest in Safe Kids Wake County.

* required info
Requesting Organization *
Contact Person *
Phone *
Email *
Location of Event *
Type of Event *
Date of Event *
Time You are Requesting *
Type of Resource Requested
If Volunteers (number needed)
If Other (describe)
What is the purpose of your event?
What community need will your organization be servicing at this event?
What population will your event reach?
Expected Attendance
Resources you can offer for this event Volunteers -
Water/Refreshments -
Discount Coupons -
Tents -
Signs -
Donation to buy car seats or helmets -
Not able to provide other resources -
Other -
If Other (list)