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Sponsored by Safe Kids Columbus; led by Piedmont Columbus Regional Midtown

Welcome to the Application Process for the Safe Kids Columbus Virtual Safe Sleep Class held on ZOOM, that includes a free portable crib (pack & play) for eligible parents/caregivers. This educational program is taught by instructors who have received their Cribs for Kids Safe Sleep Ambassador certificate. The focus of this program is on education and teaching you how to keep your baby in a safe sleep environment.

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* 1. This course requires parents/caregivers to complete online pre and post surveys.

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* 2. How did you hear about the Safe Sleep Class?

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* 3. I understand that foster parents and non-custodial grandparents or relatives are not eligible for the free portable crib (pack & play).

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* 4. I am CURRENTLY enrolled in Medicaid (Example: Amerigroup, CareSource, Peach State, Unknown)
Be prepared to show your enrollment card at the start of the online class.

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* 5. I am CURRENTLY enrolled in WIC

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* 6. I am CURRENTLY enrolled in another financially screened program not listed for low-income individuals/families or have another potentially eligible circumstance I wish to share.

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* 7. I am NOT currently in a financially screened program but I am in need of a portable crib (pack & play) because...

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* 8. Are you or your parent partner a member of any branch of the military?

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* 9. I understand that if I do not qualify for the Safe Kids equipment, I am eligible to attend the class for educational purposes only.

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* 10. I understand that I must attend a 1-hour interactive safe sleep class in order to receive a free portable crib (pack & play).

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* 11. The following class guidelines must be followed. If you are not following these guidelines, you will be dropped from the class and rescheduled.

1. When you sign onto ZOOM, be prepared to show your ID and Medicaid/WIC card.
2. You must remain in one location during the entire class.
3. You cannot drive or be a passenger in a vehicle during class.
4. You cannot be actively working while attending class.
5. You are required to keep your camera on and be on screen at all times.
6. Proper attire for a classroom setting required.
7. No talking/texting during class unless speaking with the instructor.

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* 12. Contact Information: You must live in the following counties to participate - AL: Russell GA: Muscogee

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* 13. Child's Demographic

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* 14. From the list below, please select the best option for your situation

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* 15. Have you received a free portable crib (pack and play) from Safe Kids Columbus in the past 12 months?

Next Steps:
  • Applicants accepted into our program will receive an email confirmation with class date and time.
  • Monthly classes are held at 4pm online using ZOOM
  • Drive-thru portable crib pick-up date/time will be provided during your class.
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