Certified Playground Safety Inspection Request
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Program Name
*
Address of Program
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Number of playgrounds to be inspected
*
Please indicate days and times that will work well for your inspection (Monday - Saturday). Inspections take between 1 and 1.5 hours, children should not be on playground during the inspection.
Submit
Should be Empty: