2026 Car Seat Safety Class & Giveaway

2026 Car Seat Safety Class & Giveaway

Car Seat Safety Class and Giveaway

Please limit to one household per form.
The class includes an in-person instructional session of approximately 45 minutes, followed by a hands-on demonstration of proper car seat installation. A complimentary car seat will be provided to participants. Attendance for the full duration of the class is required to be eligible for the car seat givaway. The class will be scheduled for a later date and time.

Please review and confirm that you understand all of the Car Seat Safety Class rules
- Must be a Moreno Valley resident (proof of residency required)
- One submission per household
- Only the people listed on the application may participate
- Present valid identification on the day of the event
- Limit of 1 car seat per residence (2 for twins)
*Acceptance into the program is at the discretion of the Moreno Valley Sheriff’s Station. This form is only an intake form; you will be asked to complete the full application once your submission has been reviewed and approved to continue.

*The applicant acknowledges that they own a vehicle that can accommodate a rear-facing car seat and that the rear seat belts are in safe and functional condition according to the California Vehicle Code (CVC)
Signature

Parent/Guardian and Child Information
Parent/Guardian

First NameMiddle NameLast Name
Child Information
Parent/Guardian Phone Number
Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Vehicle Information

Year, make, and model of vehicle

License plate number

City

Postal / Zip Code

I certify that the information provided above is true and accurate as of the date of signature
Date

MonthDayYear
Date
Should be Empty: