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Smoke Alarm Check Form

  1. About Smoke Alarm Checks

    On-duty fire crews will drop by your home to check your smoke alarm between 911 calls. Unfortunately, at this time, we are not able to specify a time. Therefore, please ensure that the day you request, someone will be available all day.

  2. Contact Information

  3. Smoke Alarm Service Request

    Please select service request:

  4. Electronic Signature Agreement*

    Smoke Alarm Waiver The Cosumnes CSD Fire Department has installed one or more smoke alarms or smoke alarm batteries in my home located at the address referenced on this form (hereinafter “Home”). In consideration for providing and installing battery-powered smoke alarm(s) or smoke alarm batteries in my Home, I, for myself, my heirs, executors, administrators, successors, purchasers and assigns hereby waive any and all claims for losses, injuries, liability or damages (including the payment of attorneys’ fees) against any and all individual or organizational participants in the above-referenced installation including the Cosumnes CSD, the CSD Fire Department, and their officers, trustees, agents, and employees arising out of or resulting from the installation and/or failure of the smoke alarms and/or batteries. In addition, I, for myself, my heirs, executors, administrators, successors, purchasers and assigns, further agree to defend, indemnify and hold harmless the Cosumnes CSD, the CSD Fire Department, and their officers, trustees, agents, and employees from and against any and all claims, losses, injuries, liability or damages of any kind (including the payment of attorneys’ fees) to persons or property, arising out of or resulting from the installation and failure of such smoke alarms and/or batteries in my Home. By signing this document, I certify that the smoke alarm(s) were tested in my presence and are in good working order. Furthermore, I acknowledge that I have received information from the manufacturer and/or installer regarding proper smoke alarm maintenance, and understand that the maintenance is my sole responsibility. I acknowledge having read, understood, and agreed to the above waiver, release, and indemnity.

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