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Free Helmet Application Form

  1. If request is granted, would you use free helmet on public sidewalks, roads, parks, and or skate park?*

  2. Did you know it is law that anyone under the age of 18 (minor) must wear protective head gear on public sidewalks, roads, parks, and or Skate Park?*

  3. Do you understand that you can be cited for not wearing a helmet by police or park rangers on public sidewalks, roads, parks, and or skate park?*

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  5. This field is not part of the form submission.