Car Seat Checkup Event

Car Seat Checkup Event

Please complete the information below to add your car seat checkup event(s). If you have multiple or recurring events and prefer not to submit this form for each date, you may add it as an attachment or email the event flyer/ details to BuckleUpMN@mnsc.org instead.
What is a Car Seat Checkup Event?

A car seat checkup event is typically a one-time event or a temporary, scheduled event. These events are often held periodically and are not permanent fixtures—meaning they occur on specific dates and times rather than being available on an ongoing basis.
Contact Information
Your Name (name of the person filling out the form)*

First NameLast Name
Organization Name *
Role/Title *
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email Address*
example@example.com
Event Information
Car Seat Checkup Event Name (if applicable)
Name of the car seat checkup event.
Name of Lead Certified Child Passenger Safety Technician (CPST) at this event*

First NameLast Name
Organization Name *
The name of the organization you’d like to have listed as the host for this event.
Date*

MonthDayYear
Provide the date of the car seat checkup event (if this is reoccurring, then please enter the first scheduled event and time).
Time*

Start Time

AM/PM Option

Until
until
End Time

AM/PM Option
Total 0.0
Is this a recurring event?*

YesNo
Notes about Recurring Event
(How often the event occurs, such as “third Saturday of each month,” and any additional dates or times)
Location of Car Seat Checkup Event: *
Full address of the car seat checkup event location.
County of Car Seat Checkup Event*
Is an appointment required?*

YesNo
Do you allow walk-ins or drop-ins during the car seat checkup event operating hours?*

YesNo
How do people make an appointment? Choose one or more of the options available for scheduling an appointment.*

PhoneEmailWebsiteNo Appointment Required
Phone Number
Phone number people should call to make an appointment.Format: (000) 000-0000.
Email Address
Email address for appointment scheduling inquiries.
Website for Appointment Scheduling
URL of the website where appointments can be made.
Additional Information
Do you have restrictions for who is eligible to get their car seat checked?*

YesNo
Eligibility Restrictions for Car Seat Checks:
If there are any eligibility restrictions for who can attend the event, please provide the details.
Do you charge a fee for attending this car seat event?*

YesNo
If yes, what is the fee?
Provide the fee amount and any relevant details about what the fee covers.
Do you accept donations for getting a car seat or booster seat checked at this event?*

YesNo
If yes, what fund do donations support?
(Example: injury prevention fund, car seat program, community safety fund, fire prevention fund)
Do you have a website with more information?*
Website URL:
URL of the website where appointments can be made.
Additional Information:
Any other important details, special instructions, or considerations for those attending the car seat check event.
Do you have a flyer for this event that you'd like to attach? Upload your event flyer here:

Cancelof
Would you like to include a logo for your organization? Upload your organization's logo:

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Should be Empty:

Car Seat Checkup Event

What is a Car Seat Checkup Event?

Contact Information

Event Information

Additional Information