2023 Child Passenger Safety Week/Seat Check Saturday Car Seat Check Event Registration Form

Register your Child Passenger Safety Week 2023 and/or your Seat Check Saturday car seat check event scheduled during the week of September 17 – 23, 2023. Car seat checks that are registered will be shared with the Pennsylvania Department of Transportation, provided for media releases, upon request, and posted on PA TIPP website calendar of events. PA TIPP does not need to be involved in the community car seat check event, we are merely compiling the list of events to be shared. If you are interested in receiving a list of events being held in Pennsylvania, please email aosterhuber@paaap.org. Thank you!

Question Title

* 1. What is the date & time of this event?

Start Time

Date

Time

AM/PM

End Time

Date

Time

AM/PM

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* 2. Event Location

Event Location *

Address: *

City: *

State:

ZIP/Postal Code: *

County: *

Question Title

* 3. Sponsoring Organization and Contact Information

Contact Name:

Organization:

Phone:

Email:

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* 4. Check whether appointments are required or walk-ins accepted.

Walk-Ins

Appointments Required

Appointments and Walk-Ins

Virtual Check By Appointment

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* 5. Make appointment with contact listed above?

Yes

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* 6. If no, who should be contacted for an appointment?

Name:

Phone:

Email:

Thank you for registering your community event. Please share the success of your event by completing the data collection form online at https://surveymonkey.com/r/CPSWeek2023EventData or submitting the form found on the last page of the Child Passenger Safety Week 2023 Planner.