September 2017  
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Upcoming Events
SEP

25

MON
Friends of Faith Growth Group
6:00 PM to 8:30 PM
SEP

26

TUE
Student of the Month Reception - First Flight Elem
7:30 AM to 8:15 AM
2017-2018 Student of the Month Receptions at First Flight Elementary School
Prayer Group
9:00 AM to 10:00 AM
Morning Glories Growth group
10:15 AM to 12:00 PM
SEP

27

WED
SEP

28

THU
Colington Crafters
10:00 AM to 12:00 PM
OCT

01

SUN
Sunday morning worship
9:30 AM to 10:30 AM
OCT

02

MON
Friends of Faith Growth Group
6:00 PM to 8:30 PM
OBX Quilt Guild
6:30 PM to 8:30 PM
Bible Search
Disaster Relief Registration Form

 

Colington United Methodist Church
Special Needs Registration
 
Name:___________________________________________ Date:________________________
Address: ______________________________________________________________________
Directions to your home: _________________________________________________________
______________________________________________________________________________
 
Telephone(s) (Home, Work, Cell): _________________________________________________
E-mail:________________________________________________________________________
Age: _________ Additional Info/Medical Needs: ______________________________________
______________________________________________________________________________
______________________________________________________________________________
 
Caregiver/Local Emergency Contact: ___________________________ Phone:______________
E-mail:_______________________________________________________________________
Neighbor/Other Person: __________________________________ Phone: _________________
E-mail:_______________________________________________________________________
Who will help you with emergency preparations? _____________________________________
IN THE EVENT OF A MANDATORY EVACUATION WE URGE YOU TO FOLLOW THE ORDERS OF YOUR COUNTY’S EMERGENCY MANAGEMENT GROUP. THERE ARE NO EMERGENCY SHELTERS WITHIN THE IMMEDIATE AREA. ONCE A MANDATORY EVACUATION HAS BEEN ORDERED, COLINGTON UMC WILL BE UNABLE TO CONTACT YOU UNTILTHE ORDER HAS BEEN LIFTED.
 
Do you normally evacuate if a mandatory evacuation is ordered?   □ Yes  □ No
If you answered NO, where will you stay?
 □ Home (Will you be alone? □ Yes   □ No )
 □ Family □ Friends □ Neighbor Name :______________________________________
                                                       Phone: ______________________________________
Would you like information on home safety emergency planning? □ Yes   □ No
 
Use a separate sheet of paper to add any additional information and to write your emergency planning questions and/or concerns.
COLINGTON UNITED METHODIST CHURCH
I am able to provide assistance to others during an emergency.
 


Contact Information:
Name: ___________________________
Address: _________________________
_________________________________
_________________________________
Phone: (h)________________________
            (w) ________________________
            (c) _________________________
E-mail: ___________________________
 
Check the area that most closely identifies
the area where you live:
□ Colington/ Colington Harbor
□ Corolla/Duck
□ Currituck Mainland
□   Dare Mainland
□   Hyde County
□   Kill Devil Hills
□   Manteo
□   Nags Head
□   Southern Shores
□   Wanchese
 
Please list any skills you would be willing to share: ____________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
Equipment:
Please check the equipment you have to use or lend to other members:
 
□   Boat
□   Chain Saw
□   4-wheel drive vehicle
□   Generator/Fuel Containers
□   Grills
□   Hand Tools, Wheelbarrow
□   Pickup/Straight Truck/Trailer
□   Winch/Tow Ropes/Logging Chain
□   Ladders
□   Pump (Gas powered)
□   Other: ___________________________
___________________________________
 
Services: Please check services that you are able to provide:
□   Emergency Childcare
□   Hot Meal or Covered Dish
□   Labor to prepare for a storm
□   Labor to clean up after a storm
□   Radio Operator
□   Transportation
□   Work phone bank to coordinate relief
      efforts
□   Medical Skills: ____________________
□   Other: ___________________________
Langauges: I am bilingual in English and: ____________________________________
Shelter: Please check the type of short term (up to one week) shelter you can provide:
□   Family with children: _______________
□   Family without children: ____________
□   Individuals: _______________________
□   Pets (type, #): _____________________
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