Get Farm Bureau Car Seats

Southern Farm Bureau Casualty Insurance Child-Saver Program Order Form Please print clearly legibly. You MUST complete all lines to process order Fax and phone orders not accepted* Farm Bureau Member State Required to process order Name Daytime Phone In case question about order Address No PO Boxes accepted Must use physical street address City Zip NO CHOICE in fabric pattern or color Rear Facing 5 - 40 lbs Forward Facing Only 30 100 lbs 22 40 lbs Removable fabric pad Must use vehicle lap shoulder belt Side Impact Protection Back removes for backless booster 40 100 lbs 5 point harness Removable padded fabric pad Adjustable height positions Slide out Cup holder adjustment CC047FSM Convertible Car Seat 22-491FSM High Back Booster Seat Model Description Member Price Convertible Seat 25. 00 Booster Seat 15. 00 Please make your check payable to Child Source 305 Lake Road Medina OH 44256 Total Cost Send your check/Money Order order form to Quantity Credit Cards Not Accepted Please allow 2 - 3 weeks for delivery For questions regarding your order call Child Source Customer Service 800-815-6330 ext In order to serve you better you must have your Farm Bureau member number ready when calling. You MUST complete all lines to process order Fax and phone orders not accepted* Farm Bureau Member State Required to process order Name Daytime Phone In case question about order Address No PO Boxes accepted Must use physical street address City Zip NO CHOICE in fabric pattern or color Rear Facing 5 - 40 lbs Forward Facing Only 30 100 lbs 22 40 lbs Removable fabric pad Must use vehicle lap shoulder belt Side Impact Protection Back removes for backless booster 40 100 lbs 5 point harness Removable padded fabric pad Adjustable height positions Slide out Cup holder adjustment CC047FSM Convertible Car Seat 22-491FSM High Back Booster Seat Model Description Member Price Convertible Seat 25. 00 Booster Seat 15. 00 Please make your check payable to Child Source 305 Lake Road Medina OH 44256 Total Cost Send your check/Money Order order form to Quantity Credit Cards Not Accepted Please allow 2 - 3 weeks for delivery For questions regarding your order call Child Source Customer Service 800-815-6330 ext In order to serve you better you must have your Farm Bureau member number ready when calling.