Become a Member - the Rainbow Babies & Children's Hospital Injury Prevention Center

Rainbow Babies and Children's Hospital's Injury Prevention Center

Greater Cleveland SAFE KIDS/Safe Communities Coalition Membership Application

The Coalition is designed to bring community partners together in working collaboratively to improve the health and well being of Greater Clevelanders across the lifespan and serve as a resource for organizations, agencies, companies, and individuals interested in injury prevention and health promotion.

Name

Organization

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

County

Work Phone

FAX

E-mail

Risk Area(s) Expertise or Interest

I would be interested in participating on the following action teams:

List my organization as a Greater Cleveland SAFE KIDS/Safe Communities member in local literature.