Florida Pedestrian/Bicycling Safety Resource Center Forms

Thank you for requesting materials from the Florida Pedestrian/Bicycling Safety Resource Center (SRC).


Pre-Event Forms

Community Partner Agreement Form


The Community Partner Agreement Form along with a helmet training certificate are required to order helmets. If it has been more than a year since you received your certificate, You will need to complete the refresher video here.

During Event Forms

Materials Distribution Signature Form (Helmets and Arm/Wrist Bands)

Helmets may use the pledges, surveys, or sign-in sheets (preferred).

                 Alert Today Pledge    Alert Tonight Pledge

                 Alert Today Survey   Alert Tonight Survey


Bicycle Lights

If you are a law enforcement officer in a focus county, you may order bicycle lights. You must use this form when distributing the lights.

For tangible items given at a presentation or training, return a sign-in sheet listing each participant that attended.

Print Items

Report on the number of pieces of each item distributed using the reporting feature in your profile.

Post Event Forms


Helmet Training Attendance Sheet

Regional trainers, after a class, upload your attendance list using this link, so we can provide certificates.

PedBike SRC Evaluation Form

Please help us improve our services by completing our online evaluation.