Storm Shelter Registration Form
This information is to be used by emergency personnel only in the event of an emergency. This registration helps to let us know where you may be in the event of a natural disaster if you needed to be rescued. Once submitted the Hardin County Emergency Management Agency will come to do a GPS location on your shelter. This shelter does include basements.
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Alternate Phone Number
Please enter a valid phone number.
Physical Address (No PO Boxes)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Number of People in Home
*
Special Considerations: If you have any special needs please list them here. (i.e. oxygen use, wheelchair, non-ambulatory/bedridden, etc.)
Location of Shelter
*
Basement
Front Yard
Back Yard
Garage
Other
Type of Shelter
*
Basement
Yard / Detached from Home
Garage
Safe Room
Other
Construction Type
*
Metal
Poured Concrete
Concrete Block
Other
If you selected "other" on shelter type, location, or construction type please describe here.
Please Read and e-sign:
Today's Date
*
-
Month
-
Day
Year
Date
Signature
*
Submit
Should be Empty: