Segway Children Helmets CPSC Recall Request Form

First Name *

Last Name *

Country *
USA

Address *

City *

State *
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip/Postal Code *

Phone Number *

Email *

Model Segway Kids Helmets,XS,Orange

Date of Purchase

Purchased From

Photo of Batch Code and Date * Maximum Upload Size:6MB Supported File Type:JPG,PNG,PDF,DOCX. No File Chosen Only helmets with batch code SN4500056024 and Date: August, 2020 are included in this recall.

Do you still have original box *
Yes No