Tampa Police Department Child Safety Seat Program

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Tampa Police Department Child Seat Program

Please complete all of the below information to request an appointment with a certified Child Passenger Safety Technician. You must meet all of the criteria and the 2019 U.S. Federal Poverty Guidelines listed on the previous page in order to receive a free child safety seat. Assistance with installing a child safety seat you already own does not require meeting income guidelines.

In order to qualify for the free child seat (in addition to the income requirement) you must be a City of Tampa resident. If they aren't a City resident, you may be referred to a participating agency in their area.

Parent or primary caregiver's information:

First Name

Last Name

Address

City/Town

ZIP/Postal Code

Email Address

Phone

Please answer the below questions about the child who will be using the child seat:

Child's Age

Approximate Height

Approximate Weight

Please check one of the options below

By checking this box, you as the parent/primary caregiver, are certifying that you meet the 2019 U.S. Federal Poverty Guidelines and all other criteria listed to receive a free child safety seat as part of this grant-funded program

By checking this box, you as the parent/primary caregiver, are requesting assistance only with the proper installation of a child safety seat you already own.

Please check one of the options above.

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