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GoBabyGo Registration - 2026
This program provides free, custom electric cars to children with disabilities age 1-4 who have significant mobility deficits. This program is a collaboration between the Illinois Spina Bifida Association and community partners.
Parent Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Text / SMS Opt-in
By checking this circle, you agree to receive text messages from the Illinois Spina Bifida Association related to your GoBabyGo registration at the phone number provided above. You may reply STOP to opt-out at any time. Reply HELP for assistance. Message and data rates may apply. Message frequency will vary. Learn more on our Privacy Policy page (www.i-sba.org/privacy) and Terms and Conditions (www.i-sba.org/sms).
Email
*
example@example.com
Child's Name
*
First Name
Last Name
Child's Gender
Please Select
Female
Male
Prefer not to say
Child's Date of Birth
*
-
Month
-
Day
Year
Date
Child's condition causing limited mobility
*
Child's Weight (pounds)
*
Child's Height (inches)
*
Does your child have a cognitive age of at least 12 months?
*
Yes
No
Does your child have a severe visual disorder?
*
Yes
No
Does the child have enthusiastic caregivers able to supervise use of the car?
*
Yes
No
Does your child have head and trunk control?
*
Yes
No
Can your child sit upright without support?
*
Yes
No
If your child cannot sit upright without support, do you have a seat support system that you want to use with the GoBabyGo car?
Yes
No
If yes, please tell us the dimensions (length, height, width) or name of the system.
Which of the following would be most appropriate for your child?
*
5-point harness (shoulder straps & seat belt)
Seat belt across waist
Does your child lean to one side, fall forward, or arch back (trunk extension)?
Is your child able to hold her/his head up?
*
Yes
No
If your child is not able to hold his/her head up, do you have a HeadPod Head Support System or a similar device?
Can your child reach a steering wheel and turn it?
*
Yes
No
Other
Does your child require a breathing apparatus or a feeding tube holder added to the car?
Please describe what, if any, major mobility deficits your child has in the upper and/or lower limbs.
*
Is there any other information that will help us enable your child to drive the car?
How did you hear about our program?
Submit
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