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Safe Homes Form

By filling out the form below, we pledge to have a Safe Home – Safe from Alcohol and Drugs – when hosting teen parties or gatherings in our home or on our property…

We pledge:

  • We will be present and visible
  • We will not serve or allow alcohol or drugs
  • We will call the parents of any teen possessing alcohol or drugs, or appearing to be under the influence
  • We will contact law enforcement and seek emergency medical care, if necessary

Please complete the form below. Mandatory fields marked *

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  2. *
  3. *
  4. *
  5. *
We understand that our name(s), student name(s), and grade level of our student(s) will be listed in the Safe Homes Directory and that this directory is a public document. Contact information will not be listed in the directory. We also understand that we can request to have our name(s) removed from the Safe Homes Directory at any time.


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