Please note: The Police Department will make every effort to check your residence while you are away as a courtesy and as time, activity and manpower permits. We cannot guarantee this will be done on a daily basis so please take all necessary safety precautions to safeguard your home and enlist the assistance of friends and neighbors to also check on your home. Homes for sale, homes that has been vacated by the owner or tenant, and homes where someone will be living inside the residence during your absence are not eligible for this program. Please inform us when:there is going to be a dog or other animal cared for inside your home and if you return home earlier than planned. Our officers need to know this information so there are no surprise encounters which could be dangerous. Thank you in advance and enjoy your time away!

“*Please note that this program is only available for residential properties that are temporarily vacated by its occupants and is limited to 30 calendar days. Residential properties where another person is ‘house-sitting’ are also excluded from this the vacation watch program. If you would like to make us aware of a property that may be subject to criminal activity, please contact us directly.”

I understand and hereby authorize a full disclosure of all relevant records should a missing person case involving the individual listed in Section A of this application to the Village of South Elgin Police Department and its agents and law enforcement agencies involved should an investigation be required. I also agree that such information may be reviewed and stored provided it is done so in a confidential manner and I do so regardless of any agreement I have made to the contrary with any other individual or entity to whom the missing individuals information is released or presented. I also agree to release from liability any person or entity who releases such information pursuant to an investigation. For the purpose of this release, information shall include but is not limited to all documentation and photographic images as well as the spoken word.

A photocopy or electronically transmitted facsimile of the release form will be valid as an original thereof, even though it does not bear an original representation of my signature.

I hereby agree the information I have provided the South Elgin Police Department or its agents or designees to be truthful, factual and correct. I also agree to and understand the necessity for and give authority the South Elgin Police Department, its agents or designees to release information to the Broadcaster Association and/or its associates to other commercial partners and to essential State agencies and subsidiaries for alerting the public about the individual listed in Section A of this application.

As parent/legal custodian or person responsible for the supervision this individual, I also understand that in order for the South Elgin Police Department to activate a missing person alert, each of the following criteria must be met:

•  The individual is believed to be suffering from dementia or other cognitive impairment.

•  The individual is believed to be missing regardless of circumstance.

•  The individual’s status as missing has been reported to a law enforcement agency having jurisdiction of the area in which the individual became or is believed to have become missing.

 Submission of the missing person’s report is made by any parent, spouse, guardian, legal custodian or person responsible for the supervision of the missing individual. Specific health information about the individual listed in Section A of this application, beyond the fact that the individual is believed to be suffering from dementia or some other cognitive impairment, is not made public. I am fully aware I may face criminal and/or civil penalties if providing false information to the South Elgin Police Department or any other law enforcement authority.

*Per state law all information entered into this program/database must be updated/confirmed every 2 years by the submitting person(s) or the entry shall be removed from the program/database.