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Complete the form below. Your model number with color code and
manufacturer date code MUST be included on the form to ensure
proper replacement parts. Your model number with color code and
the date code can be found on a sticker on the side of child restraint.
Payment in U.S. dollars must accompany your order. Choose parts
needed from the list on the next page.
Return the form with payment to:
Dorel Juvenile Group, Inc.
Consumer Relations Department
P.O. Box 2609
Columbus, IN 47202-2609
Fax orders to: 1-800-207-8182
Please make money orders payable to Dorel Juvenile Group, Inc. Fill
in the area below to charge to Visa or Mastercard. We do not accept
cash, personal checks, or Discover Card. All outside of U.S. and
Canada MUST use credit card.
Ship To (Please Print): _________________________________
Name: _____________________________________________
Address: ___________________________________________
City: ______________________________________________
State/Province: __________________________ Zip _________
Telephone: _________________________________________
Email Address: ______________________________________
Replacement Parts Order Form
We MUST have this information to process your order:
Model Number (8 to 9 characters): _____________________
Manufacture Date (mm/dd/yyyy): ______________________
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