Vehicle Access (if applicable)

Primary Caretaker

I hereby authorize the Hackensack Police Department and its officers, or other designated persons and employees, to use this information in locating and returning the above listed person to his/her residence should he/she become lost, missing, or disoriented. I further authorize the Hackensack Police Department to release the information provided to assist in aiding the lost/disoriented person. If registry for this individual becomes no longer necessary or if the listed information should change, I will notify the registering agency at the earliest possible moment. I understand that providing false information to a law enforcement agency is a violation of the New Jersey statute 2C:28-4. I also understand that enrollment into this registry is a privilege not to be abused nor is it intended to deprive any individual from their right to privacy or freedom, but rather to assist the registrant.