PowerHour Registration

Salulation Mr   Ms   Mrs      First Name   Last Name

City   Province  AB BC MB NB NF NS NT NU ON PE PQ SK YK

Parent Email   Phone

Number of Family Members in Your Household

My family has copleted the 4-Step Power Hour checklist Yes   No

I have followed @SafeAtHomeTips on Twitter Yes   No

Would you like to receive periodic email updates on our fire and carbon monoxide safety programs? Yes   No