If you would like to purchase a helmet for yourself or your child please fill out the order form listed below. Please register your child(ren) for the safety course, even if you do not purchase a bicycle helmet. Bicycle helmets will be available for pick-up from Monday, July 28^th – Thursday July 31^st during office hours or at the bicycle safety course on Tuesday, July 29^th. A sign will be posted at the entrance as a reminder.

SIZING CHART (based on the diameter of child’s/adult’s head)

Toddler 19.3 – 20.5”, Small 19 – 20.25”, Medium 20.25 – 21.5”, Large 21.5 – 22.75”, Xlarge 23 - 24.75”

Colors – Red or blue

Bicycle helmet orders & monies (cash or check) must be submitted to the office by Friday July 11^th !!!!

Orders and monies can be put in the “payment box”.

$ $ $ $ $ $ $ $ $ $ $ $ $ $

NAME:_______________________ ADDRESS:____________ TELEPHONE:______________

Child’s name/age____________________ Size_______ Color_______ Bicycle Safety: yes no

Child’s name/age____________________ Size_______ Color_______ Bicycle Safety: yes no

Child’s name/age____________________ Size_______ Color_______ Bicycle Safety: yes no

Child’s name/age____________________ Size_______ Color_______ Bicycle Safety: yes no

Adult’s name _______________________ Size_______ Color_______ Bicycle Safety: yes no

Adult’s name________________________ Size_______ Color_______ Bicycle Safety: yes no