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2. Broken Playground Equipment Report Form
   Let Public Services' Parks Department know of any playground equipment that needs attention or repair, and we will do our best to get it taken care of as soon as possible. Fields marked with asterisk * are required.
4. Your Contact Information
   If we have any questions, please let us know how we can contact you.
6. Name
8. Email Address
9. Phone Number
11. Contact Preference*

    1. Email me if necessary
    2. Call me if necessary
    3. Email or Call me if necessary
    4. Do Not Contact Me - I understand things might not get fixed by selecting this option.
13. Park Information
15. What Playground/Park is the equipment located?*
16. In what city?
18. Please describe the playground equipment that needs attention or repair.*
Leave This Blank:


20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit

* indicates a required field