Child Safety Seat
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Convertible Car Seat 22-120FSM
• Rear Facing
5-35 lbs.
• Forward Facing
22-40 lbs.
• Five-point harness system
• Removable, padded fabric pad
• Up-front harness adjustment
Color is factory selected •F Forward d FFacing i O Only. l 30-100 30 100 lbs. lb • Removable fabric pad; • Must use vehicle lap and
shoulder belt • Back removes for backless booster 40-100 lbs. • Easily converts to a backless booster for children 40-100 lbs. • Adjustable height positions • Slide out cup holder
Color is factory selected State:____
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Total
.Cost
Child Source 5216 Portside Drive Medina, OH 44256
** In order to serve you better, you must have your Farm Bureau member number ready when calling.**
For questions regarding your order, call Child Source Customer Service Department at 800-815-6330, ext. 18.
Please allow up to three (3) weeks for delivery.
*Limit (3) Car Seats and (3) Booster Seats per membership
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22-491FSM Cosco-High Back Booster Seat $15
Quanity _______
Member Price $25
Description 22-120FSM Cosco-Convertible Seat
Model
(No PO Boxes accepted - Must use physical street address)
City:_________________________ State: ____ Zip:___________
Address:____________________________________________
Name:_____________________________________________
Please make checks payable to: CHILD SOURCE CREDIT CARDS NOT ACCEPTED Send your check/money order & order form to:
Company Name:_______________________________ Daytime Phone #:___________________________________
(Required to process order)
Farm Bureau Member #:______________
Please print clearly and legibly. You MUST complete all lines to process order.
Fax and Phone orders not accepted.
Arkansas Farm Bureau Federation Child-Saver Program Order Form
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High Back Booster Seat Product #: 22-491RDT Produt Name: Pronto