Sarasota Car Seat Registration

Two options are available in Sarasota.

• Class: Car seat distribution event for families who need assistance with obtaining a car seat. Note: To ensure every child travels safely, our program offers car seats at a reduced cost for those that meet program criteria. Supplies are limited to 1 car seat per child and appointments are required.
• Car Seat Check: These appointments are for families who already have a car seat and need help with installation

All classes and car seat checks are held at the following location:

Outpatient Care Center, Sarasota
5881 Rand Blvd.
Sarasota, FL 34238

To register for a Class or a Car Seat Check, please complete the form below and choose the appropriate option.

Appointment Date *	7/16/2013, Clases de Silla de Carros en Espanol:  7/16/2013, Class: 12:00PM  7/16/2013, Check (have your own car seat): 12:00PM
Caregiver First Name *
Caregiver Last Name *
City
County
Phone *	() - Ext.
Email Address
Child 1: Age *
Child 1: Weight *
Child 1: Height *
Child 1: Does this child have any special needs? *
Child 1: Does this child have a car seat/booster seat? *	Yes  No
Child 2: Age
Child 2: Weight
Child 2: Height
Child 2: Does this child have any special needs?
Child 2: Does this child have a car seat/booster seat?	Yes  No
Child 3: Age
Child 3: Weight
Child 3: Height
Child 3: Does this child have any special needs?
Child 3: Does this child have a car seat/booster seat?	Yes  No
Comments for Instructor
* Required