Circle Ten Council, BSA - HELMET SAFETY BADGE

The Cub Scout must wear his helmet every time he rides his bike, rollerblades, or skateboards during a thirty day period, with a minimum of 15 different days.  The helmet must be worn the entire time of riding throughout that day.  If the Scout misses one time during that day, then it cancels that point for the day.  Use this form to keep up with the days you ride your bike, roller blade, or skateboard.  Make an X on the day when you wear your helmet.  When you have at least 15 marks in the table, and when you have answered all the questions at the bottom of the page, you will have earned the HELMET BADGE, and started a life long safety habit.  Cost of badge is $2.00.

The completed form can be brought to Scoutfitter where you may purchase the badge.  If mailing, please enclose the cost of the badge and mail to:

Circle Ten Council, BSA
8605 Harry Hines Blvd.
Dallas TX 75235-3014

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Questions:

Scout's signature ___________________________

Date ________________

Address             _____________________________________________________

City, State, Zip            ________________________________________________

Parent signature       __________________________________________________

Date    ___________

Den Leader signature   ______________________________________________    

Date    ___________

Bicycle Safety Helmet Patch Program Questions

Upon completion of the 30 day calendar, answer the questions listed below in order to complete the program.  Return this form to the Council Service Center to receive your patch.

1.  Wearing a bicycle helmet is the single most important thing you can do to protect your brain -- and your life -- when you ride your bike.  List three other activities where a  helmet should also be worn.

A.  _________________________________________________________

B.  _________________________________________________________

C.  _________________________________________________________

2. The highest rate of injury occurs to young people between ages 5 and 14.  What would you say to your friends to convince them to wear a helmet?

_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

3. Each year, emergency rooms and doctor's offices see more than 500,000 young people due to bicycle accidents.  What could you do to prepare yourself so that you are not  among those visiting either of these facilities?

_________________________________________________________

_________________________________________________________

_________________________________________________________

4. Half of all bike wrecks happen on neighborhood streets.  What precautions should be taken to assure that your bike ride is not only fun, but safe as well?

_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

5. Nationally, only 15% of all young people wear bike helmets.  List three things that you could do to help promote the wearing of a bike helmet.

A.  _________________________________________________________

B.  _________________________________________________________

C.  _________________________________________________________

6. Fill in the blanks with the words at the bottom.

Always wear a bike _____________________    .

Stop and check _____________________ before riding into a street.

Ride on the __________________ hand side of the street.

Give cars and _____________________  the right of way.

Words:  pedestrians  right  helmet  traffic