Request a Visit

For further information on scheduling the Fire Safety House, see the Fire Safety House Teacher's Packet.

Request A Visit

What type of visit are you requesting?*

Fire Safety HouseSparky PresentationAdult Fire Safety ClassDalmatian/Sparky SuitFire Extinguisher Class Please enter a Visit Type

Department Name*

Please enter only numbers 0 - 9 and characters a - z.

Contact Person*

Please enter only numbers 0 - 9 and characters a - z

Phone Number*

Please enter a valid phone number including area code. xxx-xxx-xxxx

Mailing Address (including City, State, Zip)*

Please enter a valid address, including City, State, and Zip Code.

Alt. phone number*

Please input a valid phone number. xxx-xxx-xxxx

Email*

Please enter a valid email.

Fax Number

Please enter a valid fax number.

Date Choice 1*

Please enter a valid Date

Time*

Please enter a valid time.

Date Choice 2*

Please enter a valid date.

Time *

Please input a valid time.

Date Choice 3*

Please input a valid date

Time*

Please input a valid time.

If other

Invalid Input

Have you invited the following?

Do you have a secure, flat parking area longer than 100 feet?

YesNo Invalid Input

Do you have a electrical service within100 feet of the parking area?*

Yes No Invalid Input

Describe your event:*

Invalid Input

Locaton of Event*

Please enter only numbers 0 - 9 and characters a - z.

Location Address*

Please enter only numbers 0 - 9 and characters a - z.

Phone*

Please enter a valid phone number

Backup Location (if different)

Invalid Input

Back up location address

Invalid Input

Backup Location Phone

Invalid Input

I agree that while at the above listed organization's location, all policies for the fire safety house will be followed. In addition, I agree to notify the Fire Marshal's Office of any damages of the fire safety house or any of it's contents. We will follow all applicable laws while using the fire safety house and hold harmless the City of Chattanooga, Department of Public Safety, and the Fire Marshal's Office for any negligence as a result of misconduct or improper use by the user

Signature (by typing in your name you agree to the above statement)*

You must enter your name.