Fire Safety Day Survey

1. Adults (# Attending)
2. Children (# Attending)
3. Email Address
4. Zip Code
5. What were the two most important things you learned today? (Pick two) Selection RequiredHow dangerous the smoke is during a fire. How fast the fire spreads. A closed bedroom door acts as a protective barrier between you and the smoke and flames. A fire escape plan must be created and practiced prior a fire incident.
6. Do you currently close your bedroom door prior to going to sleep? Selection RequiredYes No
7. After this event will you sleep with your door closed? Selection RequiredYes No
8. Will you plan to create and practice a fire escape plan based on what you learned today? Selection RequiredYes No
9. Do you have working smoke alarms in your house? Selection RequiredYes No
10. What are the three most important ways to be prepared for a fire in your house? (Pick three) Selection RequiredCreate and practice a fire escape plan Having working smoke alarms Close your bedroom door before you go to sleep Have a flashlight Watch videos
11. Have ever experienced a fire in your home if so, what was the cause of the fire? Selection RequiredCooking Electrical Candle Heating Other Never experienced a fire
12. Will you come back to Charlies House for additional child safety tours? Selection RequiredYes No
13. Not Used