VMAC Safe Homes Pledge
SAFE HOMES is a program that empowers parents and guardians to create a community of like-minded people who have pledged to not allow underage alcohol and drug use in their homes and on their property.
I / we agree to support the ideals of the SAFE HOME program with our children and in our home. We agree to have our contact information shared with like-minded families in Verona to facilitate the protection of our youth.
Information to be Included on the Safe Homes Contact List
Child Last Name
What school(s) do your child/children attend?
FN Brown Elementary
Our Lady of the Lake School
HB Whitehorne Middle Scool
Verona High School
Parent / Guardian First Name(s)
Parent / Guardian Last Name (if different from Child Last Name)
Contact Phone Number
Is this a Home Phone or Cell Phone?
Your email address will be used to send you the Safe Homes Contact List
Click here if you do not want your email address displayed in the Safe Homes Contact List
Please let us know if you would like additional information about the Verona Municipal Alliance Committee, including info on joining the committee
Yes, please have someone from VMAC contact me at the email address I have provided.
Yes, please have someone from VMAC contact me at the phone number I have provided.
No, not at this time.
Additional Comments / Questions for VMAC:
Page 1 of 1
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service