Register your ROTH ID TAG™

Database Registration Available Soon!

Fill out the form below to pre-register your child’s tag for the ROTH ID TAG™ Database. As soon as full registration is available you will be contacted to complete your database registration. If you have multiple children, please pre-register each of their tags individually.

Step 1 of 3

Parent/Guardian Name(Required)

First Last

Phone(Required)

Email(Required)

Enter Email Confirm Email

Child Name(Required)

First Last

Address

Street Address County State ZIP / Postal Code

Date of Birth(Required)

Your Relationship to Child(Required)

Identity Pin

In case your child's information needs retrieved in an emergency, we will use this pin to verify your child's and the emergency contacts identities.

Please enter a number from 0000 to 9999.

Does your child have medical information that would be important to know in an emergency?(Required)

Medical Information

First Emergency Contact

Name(Required)

First Last

Relationship to Child(Required)

Cell Phone(Required)

Address(Required)

City State

Second Emergency Contact

Name(Required)

First Last

Relationship to Child(Required)

Cell Phone(Required)

Address(Required)

City State

Third Emergency Contact

Name(Required)

First Last

Relationship to Child(Required)

Cell Phone(Required)

Address(Required)

City State

Phone

This field is for validation purposes and should be left unchanged.

Register your ROTH ID TAG™

Database Registration Available Soon!

First Emergency Contact

Second Emergency Contact

Third Emergency Contact

First Responder Approved

Patent-Pending Design

Made in the United States

Family Owned
& Operated

Portion of All Proceeds Donated

Register your ROTH ID TAG™

Database Registration Available Soon!

First Emergency Contact

Second Emergency Contact

Third Emergency Contact

First Responder Approved

Patent-Pending Design

Made in the United States

Family Owned & Operated

Portion of All Proceeds Donated

Family Owned
& Operated