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Complete the form on the next 2 pages. 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.
Replacement Parts Order Form
Ship To (Please Print)
Name: ________________________________
Address: ______________________________
City: _________________________________
State/Province: _________________________
Zip __________________________________
Telephone: ____________________________
Email Address:________________________
Fill in the area below to charge to Visa or
Mastercard. We do not accept personal checks
or Discover Card. All outside of U.S. and Canada
MUST use credit card.
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