Car Seat Appointment Form

Car Seat Appointment Form

By completing the information on this form, you are agreeing to attend a hands-on car seat safety training and will receive child safety information from Lexlee’s Kids via email. You must have all the requested information to have your appointment scheduled and will receive an email with instructions once the form is submitted.
  • *By providing your email address you will receive a confirmation email containing important appointment information.
  • Only enter numbers when entering phone number. ##########.
  • *We will need to know what vehicle you will be coming in even if you do not own a vehicle.
  • *Car Seat Assistance Program: Your child will receive a car seat that is appropriate for his or her age, weight & height. You must be low income or otherwise unable to afford a car seat. You will be required to make a financial donation to our agency. Donation amount and car seat types will be discussed with you when scheduling your appointment.
  • *You may enter multiple children. Please hit enter after each child.
  • *You may enter multiple ages. Please hit enter after each age.
  • *You may enter multiple birth dates (Format: 00/00/0000). Please hit enter after each date.
  • *You may enter multiple weights. Please hit enter after each weight.
  • *You may enter multiple heights. Please hit enter after each height.
  • *Some car seats may be gender specific.