Cut and paste the following with your information
and email it to:anns4boys@live.com
with the heading: Safe Homes

I have read the Safe Homes Pledge and agree to join the Bay Shore-Brightwaters Safe Homes network.

Name:

Address*:

Phone*:

Email:

I agree to join the safe homes network in Bay Shore-Brightwaters.

This is not a legally binding contract, but rather an agreement between members of the SAFE HOMES network.

*We would like to list your name as a member of the SAFE HOMES network in the SAFE HOMES Directory and other related publications.

Please indicate your choice by including only one of the following statements

___ Yes you may publish my name & phone number

____Yes you may publish my name, but not my number

____No, please refrain from including my information in these publications.

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BAY SHORE-BRIGHTWATERS SAFE HOME DIRECTORY