Safe Sleep

1.Are you a Holmes County Resident? You must be a resident to qualify for this program.
2.Parent/Guardian Name:
3.Child's Birthday or Due Date: (Child must be under the age of one to qualify)
4.Phone Number:
6.I understand I will need to arrange pick of pack 'n play at the Health District with a Health Educator.
*If you answer NO you will not be able to receive this item.