Skip to content

Residents and visitors who may require special assistance are asked to complete the form below.  Submission of the form will send your information to Rideau Lakes Fire & Rescue, and notify firefighters of extra assistance required during emergencies and natural disasters.

  • Personal Information of Applicant

    Please provide the following information about the individual choosing to provide their information for the Rideau Lakes Vulnerable Persons Registry.
  • Date Format: MM slash DD slash YYYY
  • Primary Emergency Contact Information

    Please provide the following information about the primary emergency contact for the individual identified above.
  • Secondary Emergency Contact Information

    Please provide the following information about the secondary emergency contact for the individual identified above.
  • Vulnerable Needs of Applicant

  • Please specify:
  • Please specify:
  • Please enter a number from 1 to 999.
    Note: If selected, it will not guarantee meal assistance during large-scale emergencies
  • Please provide any important additional information that will help first responders assist you during an emergency (for example, use a wheelchair).
  • Annual Updates

    Select your preferred preferences for your annual updates