Owner Will van Asch said it had been incredibly popular with more than 250 tickets having been sold before the rides started at 10am and three of the tours were fully booked out beforehand.
Napier i-Site, where the tickets were being sold, was packed and a seventh ride had been put on to accommodate the punters.
The public response for the cause had been wonderful and a member of the public had given van Asch a $100 fuel voucher to help cover the cost of the tours, he said.
Friends Narelle Renshaw and Maree McLean, from Napier, had arrived with five of their children aged between one and four for the trip.
Renshaw said she had previously been on the road train with some visitors to the region but was looking forward to taking the children as well as supporting such a good cause.
The children had been waiting excitedly for their trip this morning and McLean said she was also pleased to be going on the road train for the first time.
"The kids will love it."
Napier resident Josephine Boyd took her three grandchildren aged between six and 10 on the ride.
"I wanted to support Fred, I used to work with his mum."
Fred visited his mum's old workplace during a trip to Hawke's Bay at Christmas and was a very sweet boy, Boyd said.
"It's a great idea and a great cause."
Her grandchildren had always wanted to go on the road train but it had been too expensive, she said.
Three-year-old Napier boy Jaxon Fox brought two of his toy trains along for the ride, his mum Rylie said.
"He just loves trains and has been very excited about this trip."
A GoFundMe page, Fred's Fight, has also been set up to try to raise $25,000 to help with costs for Fred's family.
PMS is thought to affect 2.5 people out of every million.
It typically caused moderate to severe developmental and intellectual impairment, most sufferers did not acquire functional language, and about 75 per cent were diagnosed with some level of autism.
Sleep disorders were common as were problems with swallowing and eating, and about 40 per cent of people developed seizures.