Booster to Belts - Missouri

About the Program

Seat belts are designed for adults and booster seats are designed for children to help the seat belt fit correctly.

Booster to Belts is intended to be a fun, interactive presentation to teach children (Kindergarten through 3rd grade) about the importance of buckling up and using a booster seat.

Resources

Application Form

Booster to Belts presenters must complete presentations for each grade level (Kindergarten through 3rd grade) either all together in one presentation or in several smaller groups.
When giving the presentation, be lively and get kids excited about buckling up!
Once you’ve completed your presentation(s), submit the Program Completion form.

First Name(Required)

Last Name(Required)

Organization Name(Required)

Email(Required)

Phone(Required)

Shipping Address(Required)

Street Address Address Line 2 City State ZIP Code

Program Information

County(Required)

Event Location(Required)

Total Number of Students Expected (K-3rd Grade)(Required)

How did you hear about this program?(Required)

Program Completion Form

Thanks for completing the Booster to Belts program in your community! Please fill out the form below. When this form is complete, DCCCA will process your reimbursement (if applicable). If you completed the program in more than one elementary school, please fill out a separate form for each school. Kindergarten-3rd grade students at each school must receive the presentation for the speaker reimbursement. Haven’t completed the Booster to Belts program yet? Go HERE to apply!

First Name(Required)

Last Name(Required)

Make check payable to:(Required)

Email(Required)

Phone(Required)

Shipping Address(Required)

Street Address Address Line 2 City State ZIP Code

Completion Information

County(Required)

Event Location(Required)

Total Number of Students Reached (K-3rd Grade)(Required)

Date Program Completed(Required)

If completed by high school students, what club/organization did they belong to?

Comments

File Upload

Please upload 1-2 photos of your team completing the program. This must be submitted for reimbursement to be completed. The photos may be in one of these formats: JPG, GIF, PNG, or PDF.

Max. file size: 2 GB.