Membership / Supporter Form

SAFE Summerside is a group of Summerside and Area residents and visitors interested in creating safe streets for active and sustainable transportation within the City and surrounding areas. 

We aim to work with local municipal governments, businesses, and community members to develop strategies to reduce the barriers to active transportation while advocating for specific safe routes/pathways in Summerside and Area.

Membership is free and you can choose your level of involvement (Supporter, Event Volunteer, Cycling Without Age "pilot", or Planner).  Your role in this new group can be as big or small as you would like.   We are just getting "rolling," so this is pretty exciting.

Summerside and Area Personal Stories > https://safesummerside.ca/Stories
List of Current Supporters and Members > https://safesummerside.ca/index.php/about-us#members

Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
Street Address *
City/Town *
Province/State *
Phone Number
What Ward Do you Live In?  *
What District Do you Live In? *
Age Range *
This information helps us to better understand our Supporters/Members
Please check your desired forms of Active Transportation
 *
Required
How often do you use active transportation?
 *
Would you use AT more if the streets were safer (separated shared AT pathways/bike lanes, visible to public, street lights, bike storage, etc.) ?
 *
The distance between my residence and my work/frequent travel destination is?
 *
Have you ever been hit by a motor vehicle while using a form of AT (for AT or recreational)? (check all that apply) *
Required
Current Map of Pedestrian/Cyclist Collisions with Motor Vehicles
If you said you were hit while cycling, walking (using any form of AT), or if you are aware of the location of someone else being hit, can you tell us the street address (or intersection), and if it was reported it to the authorities? Format: WALKING - Intersection - Reported or Not
SAFE Summerside is collecting this data to develop an AT user map to identify trends, potential dangerous intersections, etc. We combine our data with data obtained from the City of Summerside Police Services.
Please check any barriers you face to participate more fully in AT *
Being able to identify the barriers to your participation is key when we are looking at strategies to improve your participation.
Required
Please check solutions that would help you participate more fully in AT *
We list a few of the more common solutions but feel free to add your own solution.
Required
Please identify all the streets you see as a top priority for you
 *
These streets are identifed in our draft Network Plan.  We will create a chart to accompany our submission to the City of Summerside based on what you select below. Please make sure to list your top priorities, as we will calculate the percentage of members who share the same thoughts.  What are your priorities? *=bike route; other routes all protected AT pathway
Required
Please identify all the Summerside and Area connections as you see as a priority
 *
We will create a chart to illustrate the top priority streets of SAFE Members and Supporters.  These routes are provincial responsbility and 100% provincial funded. Some of these routes have been idenfitifed in our draft document and others by community members. These routes help to create safe access at entry and exit points in Summerside and Area.  What are your priorites?
Required
Are there specific streets or intersections you would recommend crosswalk, or a sidewalk?  Please list as many as you think. If you can't think of any, just say "No".
 *
Would you support a 30 km/h speed limit in the City of Summerside? *
Research has shown the level of harm to vulnerable road users rises dramatically at speeds higher than 30 km/h. A 30 km/h speed limit has been proven to significantly reduce the fatalities associated with motor vehicle collisions.  More muncipalities and regions are lowering their speed limit.  Would you support the City of Summerside lowering its speed limit to 30 km/h?
Does the City of Summerside need safe and secure bicycle parking?
Clear selection
How best would you like to help us out?
 *
Required
Would you like to subscribe to our SAFE News?
 *
The best way to keep updated on what is happening at SAFE Summerside is to subscribe to our SAFE News. You can unsubscribe anytime, and we will never share your information. We also promise not to inundate you with emails (at most, once a month)
Are you okay if we list your name/city on our website as a Member/Supporter? *
It helps people to see a familiar name or two.  It also helps us illustrate support for AT is vast, varied, and growing.
A Personal Quote about AT?
We will post your quote on our website.  It is important to read the "real" words of "real" people. It could be a barrier you face that AT helps; it could be your education, experience, or health condition that shapes your interest. Or, it could be the state of the environment?  Whatever your reason is, we would love to hear how a safe and accessible AT community would imprive your quality of life.  This question is optional, but very much appreciated as it is the closest thing we have to your voice when we advocate for safe and accessible streets. We hope you will also send us a photo as it makes the quote "jump out" more to the readers. We may also post your quote on social media to help generate awareness.
Any Additional Comments
Feel free to any additional comments.  You may have specific projects or ideas you would like to happen.  Tell us your wish list. We are listening and are growing in numbers (thanks to people like you).
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms