Emergency Contact Information

(360) 599-2454 frontdesk@theglenatmaplefalls.org

The intent of this form is to provide Glen Office, Security and/or Maintenance staff with information that will enable us to act promptly to notify you or those you have designated when critical or emergency conditions exist. (Windstorm damage, injury or incapacity needing outside contact, etc.) Please fill out the information below. If you are choosing NOT to do so, please indicate so at the bottom of the form. The Glen would like to have a form on file for each Member property at The Glen.…and have it routinely updated to insure accuracy for you.

GLEN MEMBER CRITICAL INFORMATION
Name*
First Last
Division*
Lot #*
Your Email Address
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Mobile Phone
EMERGENCY CONTACT INFORMATION (Member Authorization)
I (as above) , Owner, Division (as above) Lot (as above), authorize Glen staff to contact the person(s) listed below in case of critical or emergency situation (as determined by the Manager) to forward information to me, or assist with needs of my lot in case of accident, injury, damage or destruction.
Agree?*
EMERGENCY CONTACT INFORMATION: (Authorized Contacts if Member is unreachable or incapacitated)
Contact 1
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone 1*
Phone 2
Email
Contact 2
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone 1
Phone 2
Email

EMERGENCY CONTACT INFORMATION

GLEN MEMBER CRITICAL INFORMATION

EMERGENCY CONTACT INFORMATION (Member Authorization)

EMERGENCY CONTACT INFORMATION: (Authorized Contacts if Member is unreachable or incapacitated)

Contact 1

Contact 2