Car Seat Check Appointment Request
Name of Child Needing Car Seat Checked
*
First Name
Last Name
How old is the child? If the child is under one year, how many months old are they?
*
Name of Parent/Guardian Attending Car Seat Check
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
We typically operate Monday - Thursday 9am to 4pm, and Fridays 9am to 12pm. Do you have a preferred day and time during these hours?
*
Do you agree to bring your child(ren) with you to your requested appointment. Please note: if the answer is no, we will not be able to accommodate your request.
*
Yes
No
I am currently pregnant
What is the year, make, and model of the vehicle that the car seat will be installed in?
*
What is the brand and model number of your current car seat?
*
If you know your child's height and weight, please enter below. If you do not know your child's height and weight, they will be taken on site during the car seat check.
*
Is there anything we should know about you, your child, your car, or your car seat prior to the car seat check?
*
Submit
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