Please fill in the form below and submit to A.Y.A. Home Watch:
E-mail Address: *
Name
Village Address
Village Phone Number
Village of
Village Mailbox Number
Billing Address
Cell Phone Number
Billing Phone Number
Start date of services
Ending date of services
Heat setting
Air setting
Freezer setting
Hot Water setting
Lawn cutting service, address, phone number
Pest Control service, address, phone number
Other service, address, phone number
Emergency Phone Number
House keys given to A.Y.A.
Mail box keys given to A.Y.A.
Cart keys given to A.Y.A.
Other keys given to A.Y.A.
Drive Cart Monthly
Start car monthly
Check golf cart battery
Other Information
Owner agreees to indemnify and hold harmless A.Y.A. Home Watch, Inc. for any damages which may occur in the event of inclimenent weather, buglaries, vandilism, gas leaks, water leaks, electrical irregularities, stored combustible/flammables, driving owners golf cart or automobile, or any acts of God that may occur while the owner is away. *