Children need a car seat that keeps them safe!
Every ride, every time!

Join us to receive general car seat and seat belt education and one-on-one help with car seat installation. You may qualify for a free car seat!

 

Question Title

* 1. Contact Information

Question Title

* 2. Are you expecting a child?

Question Title

* 3. If so, when is your due date?

Question Title

* 4. Do you currently have a child in need of a car seat?

Question Title

* 5. Age of Child

Question Title

* 6. Do you receive Government Assistance? If yes, what form of assistance? (check all that applies)

Question Title

* 7. How did you hear about this class?

Question Title

* 8. Would you like more information on the following items

T