2. Sparky’s Elmhurst Fire Safety Club

   The Elmhurst Fire Department invites all kids (up to 10 years old) who reside in Elmhurst to become members of Sparky’s Elmhurst Fire Safety Club! 

   Join by submitting this form and Sparky will reply back by mail with fire safety tips, activities, and information on upcoming events!

3. 
5. Legal Guardian's Information:
7. First Name*
8. Last Name*
10. Address1*
12. Address2
14. City*
15. State*
16. Zip*
18. Email:*
20. Child's Name:*
22. Child's Birthday:*
24. Child's Age:*
Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field