Car Seat and Booster Seat Checkup Event

Car Seat and Booster Seat Checkup Event

Please complete the information below to add your car seat and booster 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 and Booster Seat Checkup Event?

A car seat and booster 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 and Booster 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
2 digit month, 2 digit day, 4 digit yearProvide 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

End Time

AM/PM Option
Total 0.0
Is this a recurring event?
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 and Booster Seat Checkup Event:
Full address of the car seat checkup event location.
County of Car Seat and Booster Seat Checkup Event
Is an appointment required?
Do you allow walk-ins or drop-ins during the car seat and booster seat checkup event operating hours?
How do people make an appointment? Choose one or more of the options available for scheduling an appointment.
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 or booster seat checked?
Eligibility Restrictions for Car Seat or Booster 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 and booster seat checkup event?
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?
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.
Would you like a customized flyer to promote your checkup event? BuckleUpMN has a customizable event flyer available to help promote car seat and booster seat checkup events. See the sample flyer above. If you select Yes, the event information provided in this form will be used to create a customized flyer, which will be emailed to you as a ready-to-share PDF.
Do you have a flyer for this event that you'd like to attach? Upload your event flyer here:

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

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Car Seat and Booster Seat Checkup Event

What is a Car Seat and Booster Seat Checkup Event?

Contact Information

Event Information

Additional Information