Safety Net Supply Closet 
Please complete this form to request safety equipment for your home to help prevent elopement and wandering. HCPSS is pleased to provide this important support for families and grateful to the Joey Pizzano Memorial Fund (jpmf.org) for the grant that makes this possible.  
The Joey Pizzano Memorial Fund (JPMF) is a 501(c) (3) organization with a mission of improving the lives of children with special needs and their families. JPMF was founded in 1998 by Robert and Paola Pizzano after the drowning of their 6 year old son Joey. They created this fund to honor Joey’s love of water and provide water safety education for children with special needs.
**Please allow up to 2 weeks for us to process your order. We’ll reach out using the contact information you provide as soon as your order is ready. 
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Email *

Acknowledgment, Assumption of Responsibility, and Limited Release

I understand that the safety items provided through this program are for use in my home and that Howard County Public School System is not the manufacturer and does not provide installation or individualized safety advice. I am responsible for choosing, installing, and using the items per the manufacturer’s instructions and all applicable laws/codes. I understand that no product can guarantee prevention of elopement.

To the fullest extent permitted by law, I agree to release and hold harmless the Board of Education of Howard County and its officers, employees, and agents from claims arising out of my installation or use of these items, except for claims resulting from their gross negligence or willful misconduct.

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Parent/Guardian Name (First, Last)  *
HCPSS Student Name (First, Last)  *
HCPSS Student birthdate *
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HCPSS Student Name (First, Last) 
** if additional student requires a tracker please include their name 
HCPSS Student Name (First, Last) 
** if additional student requires a tracker please include their name 
Please indicate what school your child is attending *
Parent/Guardian email address (this will be the primary means of getting in touch with you to let you know your order is ready for pick up)  *
Parent/Guardian Phone number (back up means of contact for order pick up)  *
What is your household’s approximate annual income?
(This information is confidential and used only for grant reporting). Please select one option.) *
Required
How many people are in your family?  (This information is confidential and used only for grant reporting) *
Required
Does your child have a documented disability? (please check all that apply)  *
Required
Please indicate below next to the item name the quantity for each item you need at this time.  Please look for item descriptions on this page prior to ordering. Please look at the quantity limits for specific items, **if you ask for more than the specified allotment  it will delay the processing of your order for us to clarify and respond. **Please only pick 1 tracker (Apple or Android) per registered student. 
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Door Security hinge/lock (1 for each exterior door)
Door handle covers
Safety Harness (1 wrist to wrist tether per registered student)
Safety ID bracelets
APPLE GPS tracker for kids ***APPLE /IOS needed (*1 per registered HCPSS student)
ANDROID GPS tracker for kids ***ANDROID needed (*1 per registered HCPSS student)
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