TheIanTilmannFoundation.org/submissionform.html

Ian's Story

More about Ian Tilmann
Foundation

Do you Skate with a Helmet?
Join "Helmet Nation™"

Do you need a Helmet and Promise to wear one?
Join "Helmet for a Promise™"

Ian Tilmann Skate Park

Foundation Events

Sponsorships

Support the Foundation

Contact Us

Ian Tilmann Foundation

The Ian Tilmann Foundation Request Form

I am interested in:

Helmet Nation™

Helmet for a Promise™

Please choose one.

For more information,
please see: Helmet for a Promise™ or Helmet Nation™

Name

First

Last

Address

Street Address
Address Line 2
City	State / Province / Region
Postal / Zip Code	Country

Sex

Male

Female

Prefer Not to Say

Email

Facebook Address

Please Tell Us How Did You Hear About The Ian Tilmann Foundation?

Friends

Skate Magazine

Skate Park

Skate Shop

Internet

What are your Skate Disciplines?

Street

Longboard

Vert

Bowl Rider

Skate Park

Other, explain below.

Other - Explaination

Your Agreement

Yes, I agree to join the "Helmet Nation™" movement and Promise to wear a helmet whenever I Skate. I make this promise in memory of Ian Tilmann and all Fallen Skaters who have died.

I want to register for a FREE helmet by becoming a member of "Helmet for a Promise".

I want to help promote and build local support the "Helmet for a Promise™" program. Please sign me up as a Volunteer.

Yes, please let me know what to do.

No, thank you.

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We thank you for your interest and support and also thank our Helmet Suppliers for their generous support and reasonable pricing and terms that make this program possible