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2. Registration Due by July 25th
4. This year's National Night Out will be different, as we will begin to host in person events! We are glad to reconnect as a community! National Night Out is a night where people join with neighbors to support their community and deter crime. This annual event reminds residents of Crime Prevention Through Environmental Design principles, like keeping porches lit at night and keeping shrubs and trees around your property well maintained. National Night Out encourages neighbors to connect with local police officers to get involved with their community.
6. In years past, we’ve encouraged residents to get involved with their neighbors for events on National Night Out. Use the form below to register.
8. Date*
9. Police District
   -- Select One --ABCDE
10. Council District *
    -- Select One --EllicottNorthFillmoreSouthDelawareLovejoyUniversity MastenNiagara
12. Do You Belong to a Block Club?*

    1. Yes
    2. No
13. Name of Block Club ( If No Block Club put N/A)*
15. Email of Organizer*
16. Name of Organizer*
18. Responsible Individual Phone*
19. Responsible Individual Email*
21. Address
23. City
24. State
25. Zip Code
27. Are There Additional Organizers?

    1. Yes
    2. No
28. Enter Names and Emails of Additional Organizers Below
30. Event Location / Address*
32. Time of Event *
33. Expect No. of People*
35. How will your National Night Out Event Take Place? (Check all that apply)*

    1. In the Virtual Video Conference
    2. On a Porch
    3. At a Street Corner
    4. In a Yard
    5. Other
36. If selected other, please specify*
38. Use the Space Below to Provide Additional Details About Your Safety Plan (Optional)*
Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field