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Car Seat Inspection Appointment Request

  1. PoliceBadge-500x500

  2. Car Seat Inspection Appointment Request

    Inspections take place at Blaine City Hall, 10801 Town Square Drive NE.

  3. Resident of Blaine?*

  4. I acknowledge that a $25 non-resident fee applies.*

  5. Child and Car Seat Information

    (Limited to 5 children from the same family in the same vehicle.)

  6. Add Another Child?*

  7. Add Another Child?*

  8. Add Another Child?*

  9. Add Another Child?*

  10. Please note that this a request for an appointment. We will contact you to schedule the time of your appointment.

  11. Important Information Regarding Your Appointment

    This is a car seat inspection appointment. The car seat must be installed according to the car seat manual instructions and the vehicle owner's manual prior to inspection.

  12. Install your car seat(s).*

  13. Bring your car seat owners manual(s).*

  14. Bring your vehicle owners manual.*

  15. Please clean the back seat of your vehicle.*

  16. Please be prepared to provide an accurate height and weight for your child/children.*

  17. By checking this box, you agree to the wavier and liability clause.*

    This is a car seat inspection appointment. I have read and understand the information provided above.

  18. Leave This Blank:

  19. This field is not part of the form submission.