SAFE Kids in Cars Registration

SAFE Kids in Cars Registration
Our mission is to help keep our tamariki (children) safe on the roads, by having every child in the Central Taranaki areas (Stratford, Midhirst, Kaponga, Eltham areas) correctly fitted into a car-seat. Whether you have a new born, toddler or primary aged child, you can benefit from our SAFE Kids in Cars campaign.

Recieve up to $100 cash-back on new car seat restraint purchases by applying for a SAFE Kids in Cars cash-back.
- Name
  
  First NameLast Name
- Email
  example@example.com
- Phone Number
  
  Area CodePhone Number
- Address in Central Taranaki - Stratford, Kaponga, Eltham, Midhirst areas (you will need to provide proof)
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Employment Level
- Do you receive financial assistance?
- How many children/dependents do you have in your care (under 18)?
- How many of those children/dependents are under 8?
- How many car seats do you intend to purchase under cash-back?
  eg: 1
- Type of restraint needed (select all that apply)
  
  Other
- Where can you attend to have your car-seat fitted? (Please select all options that are suitable)
- Have you attended a KidSafe car-seat clinic?
- Do you agree to providing proof of address?
- Do you agree to having your car seat installed by our qualified technician within 90 days of purchase?
- In the case your cash-back request is successful, what bank account would you like the deposit made to?
- Where did you hear about the SAFE Kids in Cars campaign?
- Do you agree to receiving emails from Central Taranaki Safe Community Trust?
- Enter the message as it's shown
- Should be Empty: