Car Seat Installation Request Form

To request a car seat check or car seat installation, please complete the form below. Please note: Car seat installation is coordinated around firefighters' training schedule. Firefighters will be on-duty; therefore, they may be late or have to reschedule your installation, to respond to an emergency.

Car seat installation will be performed at Pompano Beach City Hall or one of the six Pompano Beach Fire Stations.

For Car Seat Installation requests, choose a time between 9:00am - 11:00am or between 2:00pm - 4:00pm Mon-Thurs

If the child is unborn, put NA in the applicable fields.

Caregiver First Name

Caregiver Last Name

Cell Phone

Home Address

Vehicle Year

Vehicle Make

Vehicle Model

Child's Name

Child Age

Child's Height

Child's Weight

Car Seat Manfuacturer

Car Seat Model Name

Requested Installation Date

Alternate Installation Date

I understand and agree that: The purpose of this program is to help and reduce improper use of car seats, booster seats, and seat belts and this inspection is provided as a free service to me. This program cannot fully evaluate the quality, safety, or condition of my child restraint or any component of my vehicle, including the seats, seat belt, or LATCH. This program cannot guarantee my child's safety in a crash and it is important to read both the vehicle and child restraint instruction manuals. For these reasons I release all program sponsors, volunteers, and instructors from any present or future liability for any injuries or dangers that may result from a vehicle collision or otherwise.

I Agree