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Safety Program Request Form

We are pleased to offer safety classes area schools and community groups.  Please complete the following form and we will respond with availability and class confirmation.  Please contact us at (716)338-0170 or jessica@chautauquasafetyvillage.com with any questions.

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First Name
Last Name
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Please note, there's a max of 2 programs given in one session. (ie: fire and then traffic safety) for those attending at the Safety Village.
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(Click all that apply)
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Please note: the end of April, May, June and October are peak season times for our traffic and bike safety classes. Other topics may need to be scheduled during other times.
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