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  1. Lights Inside/Outside the Home
  2. Lights On or Off
  3. Emergency Contact
  4. Does the contact have keys?
  5. Agreement*
    I understand that by checking this box I am requesting that the Garden City Police Department make periodic checks at the above location while I am away. I understand the Garden City Police Department can make no guarantees that the location will not be damaged, burglarized, or otherwise harmed, even with the additional patrols. I hereby hold the Garden City Police Department harmless for any incidents that my occur. I understand that checks will be made as Police manpower allows.
  6. Leave This Blank:

  7. This field is not part of the form submission.