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Get Child Passenger Safety Checklist

N Receiving Information) 123ABC Fill in circles like this Caregiver Last Name Street Address City State Phone Zip Email Address - - Vehicle Make/Mfg. (e.g. Chevy, Buick) Vehicle Model (e.g. Malibu, Enclave) Vehicle Year I understand and agree that the sole purpose of this program is to help reduce the incidence of improper child safety seat installation; that this inspection is being provided as a free educational service to me; that this program cannot fully evaluate the quality,.

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  3. Make sure everything is filled in correctly, without typos or lacking blocks.
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  5. Simply click Done to confirm the changes.
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  7. Submit immediately to the receiver.

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