Car Seat Check Registration Form

Free Car Seat Checks
Saturday, May 2nd. St. Paul Lutheran Church, Minden NE.

Please sign up for more than one slot if you have more than 2 seats to install.

Please call 308-832-3400 with any questions!
Full Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Select Your Time Slot*
Make/Model of Vehicle
How Many Car Seats Do You Have to Be Installed?
Please be sure to bring your car seat to the event
What Car Seat Do You Have?
Should be Empty:

Free Car Seat Checks