In times of crisis it is important for communities to help one another.
In case of an emergency, if you are registered on our Neighbors Helping Neighbors list,
you can be sure someone will be checking on you and your family.
Please fill out the following information.
Name:__________________________________________________________
Address: ________________________________________________________
Home Phone: ________________________Cell: ________________________
Email: __________________________________________________________
Number of people in the home: ______________________________________
(You can list names on the back.)
Names and types of Pets: ____________________________________________
Health problems or special needs: ______________________________________
HURRICANE SEASON: June 1st thru November 30th.
Please note: This information is for us to check on our neighbors
in case of an emergency by giving a phone call or knocking on the door.
This in no way gives permission to give medical aid.
If there is no response, we will contact 911 to make a report.
This information to held on file by the association. None of this info will appear on line for public display.
The application can be printed and mailed to:
the Highland Gardens Civic Association
2847 Plunkett St.
Hollywood, Fl. 33020