User Registration

You selected: August 12, 2022 10AM - 2PM

Registrant Information

Registrant Information

Do you need an interpreter?*
*7 day notice required for interpreter
Please specify
Are you pregnant or expecting?*
(If "Yes", don't forget to include this child below)

List All Children That Need Car Seats

Child
Has this child been born yet?*
*if child is 12-23 months, please select "1 year old"

Household Information

for text reminders
*email provided will be used for Car Seat Program communications only

Follow-up

Payment

Payment Type
Sending