City of Flin Flon - Emergency Pre-planning Registration Form
This form is intended to give the City of Flin Flon and other emergency management organizations the information they need to make sound and organized decisions for residents of Flin Flon in the event of an emergency. It is essential that everyone living in Flin Flon fill out this form, so that we understand the resources required in the event of an emergency.

Please fill out one form per household. The questionnaire will ask you how many adults or children live in your home.

When answering questions about headcount, please use numerals so that our spreadsheet can tabulate amounts properly (type "5" rather than "five", "0" rather than "none", etc.)
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Full Name *
Full Name of Partner/spouse (if applicable):
Home/Street Address (write n/a if you do not have housing): *
Mailing Address with Box Number: *
Phone Number (put n/a if you do not have a phone): *
Email Address (put n/a if you do not have an email address): *
If you do not have a phone or email address, what is the best way to contact you in an emergency? (Write n/a if not applicable) *
How many adults live in your home? (Please use numerals) *
Number of children ages 13 or over (Please use numerals): *
Number of children ages 12 or under (Please use numerals): *
Do you have a safe and reliable place to stay if you have to evacuate, like family, friends, a camper/rv, etc? *
What form of transportation does your household plan to use in the event of an evacuation? *
Do you have cats? How many? (Please use numerals) *
Do you have dogs? How many? (Please use numerals) *
Do you have any other pets? What kind? (Write n/a if you have no other pets) *
Will you be bringing pets with you if you need to evacuate? (Pets must be contained in a carrier or leashed if using provincial transportation): *
Do you have medical or mobility issues that may be important to know if the community is evacuated? *
If you do have medical or mobility issues, please describe them.
Is there anything else we may need to know about your household in the event of an evacuation?
Are your registered with Flin Flon Connect? If you are not, we strongly recommend you sign up for the service. You can register at https://www.cityofflinflon.ca/p/flin-flon-connect *
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