Helmet Request Form

If you're planning on hosting an event where kids are getting taught how to fit and wear a helmet, you can request up to 20 free helmets to give away at your event. Please fill out the form below (United States only please) and someone will get in touch with you to discuss. Please ensure you submit the form at least 2 weeks prior to your event. We're happy to fulfill one request per organization

^*Denotes a required field

First Name ^*

Last Name ^*

Phone ^*

Email ^*

School/Org. ^*

Address ^*

Address 2

City ^*

State ^*

Please Select A State AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Zip Code ^*

Number of Kids Educated ^*

Event Description ^*

By checking this box I certify that I will be using the requested helmets for educational and fitting purposes only. ^* Submit