Your Name -or- Your Child's Name
*
Please put your name or complete the form for your minor child. If multiple adults live in your home, please have them each fill out the form with their information.
First Name
Last Name
Parent Or Guardian's Name (if applicable)
If you are completing this for your minor child and you are his or her parent or legal guardian, please put your name below.
First Name
Last Name
Minor's DOB (if applicable)
MM
DD
YYYY
Gender Pronouns
*
What are your preferred gender pronouns?
Phone
*
(###)
###
####
Email
*
FWSD/MUD/City
*
Which FWSD/MUD or town do you live in? Please check Denton CAD if you are ensure. There are detailed instructions on the FAQ page. A very small amount of us live in Lakeside Estates, so the taxing authority will show as Little Elm and they will receive their water from Little Elm - NOT Mustang.
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Potentially Vulnerable Person
If there is anyone in your household, including yourself, that has any kind of special circumstances (e.g., homebound that may be alone, on life support, has a memory disorder, chronically ill, elders, young children that walk to/from school, ASD, hearing impaired, blind, confined to wheelchair), please let us know so we can help.
Make - Vehicle One
Model - Vehicle One
Year - Vehicle One
Color - Vehicle One
Plate Number - Vehicle One
Make - Vehicle Two
Model - Vehicle Two
Year - Vehicle Two
Color - Vehicle Two
Plate Number - Vehicle Two
Schedule
What is your regular work schedule and routine? You may need to list one pre-COVID and during shutdown.
Pets
Please list each pet's name, weight, age, species, breed, collar/no collar, and microchip status.
Alarm Company Phone Number
(###)
###
####
Comments or Questions
Is there anything else that you would like to share? Do you have any personal or professional skills that would enhance the neighborhood crime watch? Are you a cat or dog person?
Emergency Contact - One
Please list someone that lives outside of your home that you would like contacted in the event of an emergency.
First Name
Last Name
Emergency Contact - One
(###)
###
####
Emergency Contact - Two
First Name
Last Name
Emergency Contact - Two
(###)
###
####
Volunteer's Areas Of Interest -OR- Member Only
*
Please tell us all of the areas that you are interested in volunteering and if there is somewhere that you are uniquely qualified that isn't listed, please tell us about it in the comments section:
Liability Waiver
*
By checking this box, I understand that I should not confront a suspect during the commission of a crime or after seeing it occur. I will NOT get involved in a conflict with the suspect. I will not attempt to make a citizen’s arrest, “hold” the suspect for authorities, or insert myself in the situation in a way other than safely observing and reporting. I acknowledge that it is unacceptable to harass or stalk a convicted or alleged criminal. I understand that anyone who participates in any kind of vigilante justice will be prosecuted to the fullest extent of the law. I will observe and report crimes in progress to 911 and use the non-emergency number for all other issues that are not urgent in nature. I acknowledge that all information that I disclose to the crime watch can be used for testimonial purposes at the discretion of a member of the Steering Committee. I understand that I am joining the Paloma Creek Neighborhood Crime Watch at my own risk. I, and any potential heirs, HOLD HARMLESS AND RELEASE Paloma Creek Neighborhood Crime Watch, City of Little Elm, City of Little Elm Police Department, Denton County, Denton County Sheriff's Office, all five FWSDs, Paloma Creek HOA, as well as the entities' leadership, members, employees, volunteers, representatives, elected officials, and affiliates not liable for any and all claims that may result from any claims and causes of action, including, but not limited to personal injury, property damage, or lawsuits that may result from my actions.
