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Vacation House Check Request Form

  1. Woodland Police Coin Image
  2. Vacation House Check Request Form
    The vacation check does not guarantee that a burglary or other crime will not occur at the residence, and it is only intended to be a request for our police department representative to check the home periodically, based upon the availability of the officer or citizen volunteer. Consequently, it is highly recommended that you make every effort to safeguard against losses including securing of high value property, proper locking devices, alarm systems, etc. No vacation checks while the homeowner is gone from the home are guaranteed. No further police response or protection is being guaranteed by the vacation check other than the normal police service and protection, which is provided to the general public.
  3. Notifications
    Please give us at least 3 days’ notice before you leave. We may need to ask for additional information. If you arrive home early from your vacation, you are responsible to contact the police Department right away.
  4. Emergency Contact Information
    Please list the information of a relative, friend or neighbor that we can contact in the event we are not able to reach you.
  5. Are there cars in the driveway?*
  6. Include as much information as possible: Make, Model, Year, Color, License Plate Number, etc.
  7. Do you have interior lights left on a timer?
  8. Are you exterior lights left on a timer?
  9. Do you have Surveillance Cameras?
  10. Do you have an operational alarm system?
  11. If you will have any animals at your home while you are away, please describe them, where they will be and the name and phone number of the person will be caring for them regularly.
  12. Release of Liability
    I release the city of Woodland Police Department from any liability if my home should happen to be burglarized or suffer any damage during my absence. I am aware that this service is contingent on the availability of volunteer//officer personnel.
  13. Electronic Signature Agreement*
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
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  15. This field is not part of the form submission.