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Vacation Watch Registration Form

  1. Alarm

  2. Timers

  3. Vehicles on Premise

  4. Person/Persons remaining on Premise

  5. Note:

    THE UNDERSIGNED ACKNOWLEDGES THAT THE IHPPD VACATION HOUSE WATCH PROGRAM IS VOLUNTARY, & IS NOT CONTRACTUAL. PARTICIPATION IN THE PROGRAM DOES NOT ASSURE ANY PARTICULAR LEVEL OF POLICE PROTECTION; THAT SUCH PARTICIPATION DOES NOT CREATE ANY SPECIAL DUTY TOWARD THE UNDERSIGNED ON THE PART OF THE VILLAGE, ITS OFFICERS OR AGENTS; AND THAT THE UNDERSIGNED HOLDS THE IHPPD HARMLESS FOR ANY CLAIMS ARISING OUT OF ANY NATURE OCCURRING ON OR ABOUT OUR PROPERTY WHILE WE ARE ON VACATION.

  6. Signature

    By checking this box, I authorize my signature.

  7. Leave This Blank:

  8. This field is not part of the form submission.