******************** Attach this portion to the car seat ********************

 

            POMBA Halifax Region 

           CAR SEAT & BOOSTER SEAT SAFETY WAIVER 

 

 

 

 

BRAND: ____________________________MODEL:  ____________________________ 

 

MANUFACTURE YEAR: _______________ 

 

I AFFIRM THAT:

___The above car seat has not been in an automobile incident (with or without child sitting in it)

___ I have checked for safety recalls and have made any necessary safety retrofits required.

___I have included the instructional manual.

___If manufactured before January 2012, email verification from the company that the car seat meets current regu

tions is attached.

 

Seller’s Name ___________________________________________ Date__________, 20___ 

  

Seller’s Signature ________________________________________  

 

 

  ----------------------------------------------------------------------------------------------

********************Leave this portion with the Check-in Desk ********************

 

         POMBA Halifax Region 

           CAR SEAT & BOOSTER SEAT SAFETY WAIVER 

 

 

 

 

BRAND: ____________________________MODEL:  ____________________________ 

 

MANUFACTURE YEAR: _______________ 

 

I AFFIRM THAT:

___The above car seat has not been in an automobile incident (with or without child sitting in it)

___ I have checked for safety recalls and have made any necessary safety retrofits required.

___I have included the instructional manual.

___If manufactured before January 2012, email verification from the company that the car seat meets current regu

tions is attached.

 

Seller’s Name ___________________________________________ Date____________, 20___

 

  

Seller’s Signature ________________________________________  

 

 

  --------------------------------------------------------------------------------------------- 

Please hand in your waiver on the Friday as you check in.  

ONLY CAR SEATS THAT MEET THE  

JANUARY 2012 REGULATIONS MAY BE SOLD.