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Safe Room/Storm Shelter Registration

  1. Person(s) physically living at the Address listed above.

  2. Phone number of Owner/Resident where shelter is located

  3. Alternate phone number contact for person(s) that may be located in shelter

  4. Occupancy Use:*

    Use of the property

  5. Adults Inside*

    Number of Occupants inside shelter

  6. Children Inside*

  7. Pets Inside*

    Number of Pets inside shelter

  8. Emergency Supplies*

    Water, Food, Medication within Shelter

  9. Fill out field with any special medical needs, like Oxygen, High Blood Pressure, Heart Patient, etc.

  10. Approx Year that Safe Room was installed/constructed. If cellar, date not needed

  11. Rent House*

    Select whether or not this is a rental or not.

  12. Leave This Blank: