Board of Directors

EMERGENCY
CONTACT FORM

This information will be transferred and stored on the Emergency Cards and Master database in the office. All electronic copies will be immediately destroyed.
All information is for the private use of the Briar Creek Mobile Home Community 1, Board of Directors
This information can not be requested by friends or others. If you wish to share this information please do so privately with those individuals,
a Board member will not share this information and will only use the information in the event of an emergency that threaten life or property.

EMERGENCY INFORMATION CARD

First Name 1: Last Name1 :

First Name 2: Last Name 2:

If different from Last Name 1

Address Line 1:

Briar Creek Address

E-Mail Address

If you leave for any length of time

Summer Address City, St Zip:

Phone Number: Cell/Other Phone:

EMERGENCY CONTACTS

Contact Name
Contact Phone Contact Cell / Other Phone

Contact Name
Contact Phone Contact Cell / Other Phone

EMERGENCY ACCESS

Who has key when away or where is it located

Key Contact Phone
Who can we contact

Other Comments: