Please fill out an Emergency Contact form for EACH person living in the house that is 18 years old or older. We require 4 emergency contacts per Resident, each contact must include full name, full address and phone number. Each contact must have a different address and can only be used once per household (2 adults in house require 8 different people). Each blank requires information.
First name*
Middle name*
Last name*
Current address*
City, state, and zip*
Date of birth*
Social security number*
Daytime phone*
Cell phone*
Enter your email Address* (Must be a valid email address to complete this form. If you need a free email address, click here)
Most Trusted Person-Emergency Contact #1.
In case of death, incapacitation, or incarceration, I authorize this person to remove my personal items.
Emergency Contact #1 full name*
Your relationship to Emergency Contact #1*
Emergency Contact #1 full address*
Emergency contact #1 phone number*
Emergency Contact #2
Emergency Contact #2 full name*
Your relationship to Emergency Contact #2*
Emergency Contact #2 full address*
Emergency Contact #2 phone number*
Emergency Contact #3
Emergency Contact #3 full name*
Your relationship to Emergency Contact #3*
Emergency Contact #3 full address*
Emergency Contact #3 phone number*
Emergency Contact #4
Emergency Contact #4 full name*
Your Relationship to Emergency Contact #4*
Emergency Contact #4 full address*
Emergency Contact #4 phone number*
Digital signature*
“I AGREE AND GRANT PERMISSION TO GRAYSON PROPERTY MANAGEMENT TO CONTACT REFERENCES AND EMERGENCY CONTACTS IN THE EVENT RESIDENT CANNOT BE REACHED OR IS NON-RESPONSIVE TO MANAGEMENT CALLS OR NOTICES, AND AGREES THAT NOTICE TO THOSE CONTACTS IS CONSIDERED LEGAL SERVICE. I AGREE THAT MY REFERENCES AND EMERGENCY CONTACTS MAY RELEASE PERSONAL INFORMATION TO GRAYSON PROPERTY MANAGEMENT (LISTED OR UNLISTED) AT ANY TIME. THIS FORM IS NOT CONFIDENTIAL. I CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND THAT I AM 18 YEARS OR OLDER.
* Resident, Please type your full name into this box. By typing your full name, you are digitally signing the Emergency Contact form and granting permission to Grayson Property Management to contact references and emergency contacts in the even resident cannot be reached or is non-responsive to management calls or notices, and agrees that notice to those contacts is considered legal service. I agree that my references and emergency contacts (listed or unlisted) may release personal information to Grayson Property Management at any time. This form is not confidential. I certify that the above information is true and that I am 18 years or older.
"I, (the Resident and signer), grant permission to receive calls and text messages on my cell phone, home phone, work phone, email, and/or receive mail at my current address. I certify that the above information is true and that I am 18 years or older." This form is not confidential.
