Register - Agoura Hills Fire Safe Council

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Name(Required)

First Last

Email(Required)

Phone

Address

Street Address Address Line 2 City State ZIP Code

Home Owner or Renter(Required)

Home Owner

Renter

Management Company

None of the above

HOA/Community (For Agoura Hills, CA Residents)

Please select your Home Owner's Association (HOA). If you do not have one or are not sure of your HOA, please select "No HOA." If your HOA is not listed here, please let us know the name of your HOA using the "Notes" field below.

Would you like to receive our newsletter?

We email out an informative monthly newsletter of important information about keeping your property safe from wildfires

Yes

I am an At Risk Resident

I am an "At Risk Resident," disabled or elderly, who may need assistance in the event of a wildfire. I understand that I will be added to a volunteer phone tree that will try to contact me to see if I need assistance in the event of a wildfire. The Agoura Hills Fire Safe Council is not an emergency service and should not be relied on for assistance. By checking this box you understand and agree to the conditions that our At Risk Resident phone tree is provided under the "Good Samaritan Laws" which protects people who provide reasonable assistance to those who are injured ill or incapacitated. The phone tree and assistance is not guaranteed. If you checked this checkbox, please be sure you have supplied us with your correct up-to-date phone number, email address, and home address. Please follow your local Fire Department's evacuation recommendations.

I am an At Risk Resident

Notes

Have questions? How can we help you?

Name

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