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content="If you need assistance, please complete this form. BE AS THOROUGH AS POSSIBLE.
On September 4th, we updated our rescue (this) form as our team begins to transition from rescue operations into wellness and relief. If you have an emergency situation and need to be rescued, we recommend you still complete this form, text RESCUE to 33222, and call 911.

Facebook group: https://www.facebook.com/groups/831235773703488/
Facebook page: https://www.facebook.com/HHVolunteerRescue/ 
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.25s}.gb_kc.gb_tb{width:264px;transform:translateX(-264px)}.gb_kc:not(.gb_tb){width:280px;transform:translateX(-280px)}.gb_kc.gb_g{transform:translateX(0);visibility:visible;box-shadow:0 0 16px rgba(0,0,0,.28);transition:transform .25s cubic-bezier(0.4,0.0,0.2,1),visibility 0s linear 0s}.gb_lc.gb_mc{background-color:transparent;box-shadow:0 0}.gb_lc.gb_mc>:not(.gb_nc){display:none}.gb_nc{display:-webkit-flex;display:flex;flex:1 1 auto;flex-direction:column}.gb_nc>.gb_oc{flex:1 0 auto}.gb_nc>.gb_pc{flex:0 0 auto}.gb_qc{list-style:none;margin-top:0;margin-bottom:0;padding:8px 0}.gb_kc:not(.gb_lc) .gb_qc:first-child{padding:0 0 8px 0}.gb_qc:not(:last-child){border-bottom:1px solid #ddd}.gb_rc{cursor:pointer}.gb_sc:empty{display:none}.gb_rc,.gb_sc{display:block;min-height:40px;padding-bottom:4px;padding-top:4px;font-family:Roboto,RobotoDraft,Helvetica,Arial,sans-serif;color:rgba(0,0,0,0.87)}.gb_kc.gb_tb .gb_rc{padding-left:16px}.gb_kc:not(.gb_tb) .gb_rc,.gb_kc:not(.gb_tb) 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svg{display:block}.gb_xe.gb_Qc svg{display:none}.gb_Hc .gb_we{color:white;background-color:#db4437;opacity:1}.gb_ae .gb_Hc .gb_we{color:white;background-color:#db4437}.gb_be .gb_Hc .gb_we{color:#212121;background-color:white}.gb_ye{display:none}.gb_uf{cursor:pointer;padding:13px}.gb_vf{background-color:rgba(0,0,0,0.1);box-shadow:inset 1px 1px 3px rgba(0,0,0,.24);width:34px;height:17px;border-radius:8px;position:relative;transition:background-color ease 150ms}.gb_uf[aria-pressed=true] .gb_vf{background-color:rgba(255,255,255,0.1)}.gb_wf{position:absolute;width:25px;height:25px;border-radius:50%;box-shadow:0 0 2px rgba(0,0,0,.12),0 2px 4px rgba(0,0,0,.24);top:-4px;transform:translateX(-12px);background-color:white;transition:transform ease 150ms}.gb_uf[aria-pressed=true] .gb_wf{transform:translateX(20px)}.gb_wf img{position:absolute;margin:5px;width:15px;height:15px}.gb_Td{line-height:0}.gb_Rd>.gb_Td:only-child{float:right}.gb_Td .gb_De{display:inline-block}.gb_Td .gb_Eb{cursor:pointer}.gb_Td .gb_Eb img{opacity:.54;width:24px;height:24px;padding:12px}.gb_be .gb_Td .gb_Eb img{opacity:1}.gb_ze{text-align:right}.gb_De{text-align:initial}.gb_Td .gb_Ee,.gb_Td .gb_Fe{display:table-cell;height:48px;vertical-align:middle}.gb_Td .gb_Ee{overflow:hidden}.gb_Uc{display:none}.gb_Uc.gb_g{display:block}.gb_Vc{background-color:#fff;box-shadow:0 1px 0 rgba(0,0,0,0.08);color:#000;position:relative;z-index:986}.gb_Wc{height:40px;padding:16px 24px;white-space:nowrap}.gb_Xc{position:fixed;bottom:16px;padding:16px;right:16px;white-space:normal;width:328px;transition:width .2s,bottom .2s,right .2s;border-radius:2px;box-shadow:0 5px 5px -3px rgba(0,0,0,0.2),0 8px 10px 1px rgba(0,0,0,0.14),0 3px 14px 2px rgba(0,0,0,0.12)}@media (max-width:400px){.gb_Vc.gb_Xc{max-width:368px;width:auto;bottom:0;right:0}}.gb_Vc .gb_Eb{border:0;font-weight:500;font-size:14px;line-height:36px;min-width:32px;padding:0 16px;vertical-align:middle}.gb_Vc 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.gb_ad{width:200px}.gb_cd{color:#333333;font-size:16px;line-height:20px;margin:0;margin-bottom:16px}.gb_8c .gb_cd{color:#ffffff}.gb_5c{color:#666666;line-height:17px;margin:0;margin-bottom:5px}.gb_8c .gb_5c{color:#ffffff}.gb_ld{text-decoration:none;color:#5e97f6}.gb_ld:visited{color:#5e97f6}.gb_ld:hover,.gb_ld:active{text-decoration:underline}.gb_md{position:absolute;background:transparent;top:-999px;z-index:-1;visibility:hidden;margin-top:1px;margin-left:1px}#gb .gb_7c{margin:0}.gb_7c .gb_Eb{background:#4d90fe;border-color:#3079ed;margin-top:15px}.gb_bd .gb_Fa{background:#4285f4}#gb .gb_7c a.gb_Eb.gb_Eb{color:#ffffff}.gb_7c .gb_Eb:hover{background:#357ae8;border-color:#2f5bb7}.gb_nd .gb_Nc .gb_qb{border-bottom-color:#ffffff;display:block}.gb_od .gb_Nc .gb_qb{border-bottom-color:#4d90fe;display:block}.gb_nd .gb_Nc .gb_rb,.gb_od .gb_Nc .gb_rb{display:block}.gb_pd,.gb_hd{display:table-cell}.gb_pd{vertical-align:middle}.gb_bd 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On September 4th, we updated our rescue (this) form as our team begins to transition from rescue operations into wellness and relief. If you have an emergency situation and need to be rescued, we recommend you still complete this form, text RESCUE to 33222, and call 911.

Facebook group: https://www.facebook.com/groups/831235773703488/
Facebook page: https://www.facebook.com/HHVolunteerRescue/ 
"><meta itemprop="faviconUrl" content="https://ssl.gstatic.com/docs/spreadsheets/forms/favicon_qp2.png"><meta itemprop="url" content="https://docs.google.com/forms/d/e/1FAIpQLScv3sJ-wuaupWKVjCTR6Oexxy1X1RzKTgpdfhT0XDTSP22b2A/viewform?usp=embed_googleplus"><meta itemprop="embedURL" content="https://docs.google.com/forms/d/e/1FAIpQLScv3sJ-wuaupWKVjCTR6Oexxy1X1RzKTgpdfhT0XDTSP22b2A/viewform?embedded=true&amp;usp=embed_googleplus"><meta itemprop="thumbnailUrl" content="https://ssl.gstatic.com/docs/forms/social/social-forms-big-2.png"><meta itemprop="image" content="https://ssl.gstatic.com/docs/forms/social/social-forms-big-2.png"><meta itemprop="imageUrl" content="https://ssl.gstatic.com/docs/forms/social/social-forms-big-2.png"><div class="freebirdFormviewerViewFormContentWrapper"><div class="freebirdFormviewerViewFormBanner freebirdHeaderMast"></div><div class="freebirdFormviewerViewCenteredContent"><form action="https://docs.google.com/forms/d/e/1FAIpQLScv3sJ-wuaupWKVjCTR6Oexxy1X1RzKTgpdfhT0XDTSP22b2A/formResponse" target="_self" method="POST" id="mG61Hd"><div class="freebirdFormviewerViewFormCard"><div class="freebirdFormviewerViewAccentBanner freebirdAccentBackground"></div><div class="freebirdFormviewerViewFormContent "><div class=freebirdFormviewerViewNoPadding><div class="freebirdFormviewerViewHeaderHeader"><div class="freebirdFormviewerViewHeaderTitleRow"><div class="freebirdFormviewerViewHeaderTitle freebirdCustomFont" dir="auto" role="heading" aria-level="1">HHVR Request for Aid</div></div><div class="freebirdFormviewerViewHeaderDescription" dir="auto">If you need assistance, please complete this form. BE AS THOROUGH AS POSSIBLE.<br>On September 4th, we updated our rescue (this) form as our team begins to transition from rescue operations into wellness and relief. If you have an emergency situation and need to be rescued, we recommend you still complete this form, text RESCUE to 33222, and call 911.<p>Facebook group: <a href="https://www.google.com/url?q=https://www.facebook.com/groups/831235773703488/&amp;sa=D&amp;ust=1518585956550000&amp;usg=AFQjCNFyhL4McroObINx58ixObOe3Kg2nA">https://www.facebook.com/groups/831235773703488/</a><br>Facebook page: <a href="https://www.google.com/url?q=https://www.facebook.com/HHVolunteerRescue/&amp;sa=D&amp;ust=1518585956550000&amp;usg=AFQjCNG0inL9iSYzoz7AT4qfSimIjNXcqg">https://www.facebook.com/HHVolunteerRescue/</a> <br></p></div><div jsname="F0H8Yc" class="freebirdCommonViewSecurequizSecureQuizBannerContainer"></div><div class="freebirdFormviewerViewHeaderRequiredLegend" aria-hidden="true" dir="auto">* Required</div></div></div><div class=freebirdFormviewerViewItemList role="list"><div role="listitem" class="freebirdFormviewerViewItemsItemItem" jsname="ibnC6b" jscontroller="pkFYWb" jsaction="sPvj8e:F0ZU4;" data-required="true" data-other-input="qSV85" data-other-hidden="MfYA1e" data-item-id="537216565"><div class="freebirdFormviewerViewItemsItemItemHeader"><div class="freebirdFormviewerViewItemsItemItemTitleContainer"><div class="freebirdFormviewerViewItemsItemItemTitle freebirdCustomFont" dir="auto" id="i1" role="heading" aria-level="2" aria-describedby="i.desc.537216565 i4">Request type <span class="freebirdFormviewerViewItemsItemRequiredAsterisk" aria-label="Required question">*</span></div><div class="freebirdFormviewerViewItemsItemItemHelpText" id="i.desc.537216565" dir="auto"></div></div></div><div jscontroller="eFy6Rc" jsaction="sPvj8e:Gh295d" jsname="cnAzRb" data-input="L9xHkb"><div jscontroller="wPRNsd" jsshadow jsaction="keydown: I481le;JIbuQc:JIbuQc;rcuQ6b:rcuQ6b" jsname="wCJL8" aria-labelledby="i1" aria-describedby="i.desc.537216565 i.err.537216565" aria-required="true" role="radiogroup"><content role="presentation" jsname="bN97Pc"><div class=""><label class="docssharedWizToggleLabeledContainer freebirdFormviewerViewItemsRadioChoice"><div class="exportLabelWrapper"><div class="quantumWizTogglePaperradioEl docssharedWizToggleLabeledControl freebirdThemedRadio freebirdThemedRadioDarkerDisabled freebirdFormviewerViewItemsRadioControl" jscontroller="EcW08c" jsaction="click:cOuCgd; 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focus:Jt1EX; blur:fpfTEe; input:Lg5SV;" jsshadow jsname="W85ice"><div class="quantumWizTextinputPaperinputMainContent exportContent"><div class="quantumWizTextinputPaperinputContentArea exportContentArea"><div class="quantumWizTextinputPaperinputInputArea"><input type="text" class="quantumWizTextinputPaperinputInput exportInput" jsname="YPqjbf" autocomplete="off" tabindex="0" aria-label="City" aria-describedby="i.desc.207809553 i.err.207809553" name="entry.858559450" value="" required dir="auto" data-initial-dir="auto" data-initial-value=""/><div jsname="LwH6nd" class="quantumWizTextinputPaperinputPlaceholder exportLabel" >Your answer</div></div><div class="quantumWizTextinputPaperinputUnderline exportUnderline"></div><div jsname="XmnwAc" class="quantumWizTextinputPaperinputFocusUnderline exportFocusUnderline"></div></div></div><div class="quantumWizTextinputPaperinputCounterErrorHolder"><div jsname="ty6ygf" class="quantumWizTextinputPaperinputHint exportHint"></div></div></div></div><div class="freebirdFormviewerViewItemsItemGradingGradingBox freebirdFormviewerViewItemsItemGradingFeedbackBox" jsname="R7fTud"></div><div jsname="XbIQze" class="freebirdFormviewerViewItemsItemErrorMessage" id="i.err.207809553" role="alert"></div></div><div role="listitem" class="freebirdFormviewerViewItemsItemItem freebirdFormviewerViewItemsTextTextItem" jsname="ibnC6b" jscontroller="rDGJeb" jsaction="sPvj8e:e4JwSe,vwKRrd;" data-required="true" data-item-id="1028014696"><div class="freebirdFormviewerViewItemsItemItemHeader"><div class="freebirdFormviewerViewItemsItemItemTitleContainer"><div class="freebirdFormviewerViewItemsItemItemTitle freebirdCustomFont" dir="auto" role="heading" aria-level="2" aria-describedby="i.desc.1028014696 i31">State <span class="freebirdFormviewerViewItemsItemRequiredAsterisk" aria-label="Required question">*</span></div><div class="freebirdFormviewerViewItemsItemItemHelpText" id="i.desc.1028014696" dir="auto"></div></div></div><div class="freebirdFormviewerViewItemsTextItemWrapper"><div class="quantumWizTextinputPaperinputEl freebirdFormviewerViewItemsTextShortText freebirdThemedInput" jscontroller="pxq3x" jsaction="clickonly:KjsqPd; focus:Jt1EX; blur:fpfTEe; input:Lg5SV;" jsshadow jsname="W85ice"><div class="quantumWizTextinputPaperinputMainContent exportContent"><div class="quantumWizTextinputPaperinputContentArea exportContentArea"><div class="quantumWizTextinputPaperinputInputArea"><input type="text" class="quantumWizTextinputPaperinputInput exportInput" jsname="YPqjbf" autocomplete="off" tabindex="0" aria-label="State" aria-describedby="i.desc.1028014696 i.err.1028014696" name="entry.404511315" value="" required dir="auto" data-initial-dir="auto" data-initial-value=""/><div jsname="LwH6nd" class="quantumWizTextinputPaperinputPlaceholder exportLabel" >Your answer</div></div><div class="quantumWizTextinputPaperinputUnderline exportUnderline"></div><div jsname="XmnwAc" class="quantumWizTextinputPaperinputFocusUnderline exportFocusUnderline"></div></div></div><div class="quantumWizTextinputPaperinputCounterErrorHolder"><div jsname="ty6ygf" class="quantumWizTextinputPaperinputHint exportHint"></div></div></div></div><div class="freebirdFormviewerViewItemsItemGradingGradingBox freebirdFormviewerViewItemsItemGradingFeedbackBox" jsname="R7fTud"></div><div jsname="XbIQze" class="freebirdFormviewerViewItemsItemErrorMessage" id="i.err.1028014696" role="alert"></div></div><div role="listitem" class="freebirdFormviewerViewItemsItemItem freebirdFormviewerViewItemsTextTextItem" jsname="ibnC6b" jscontroller="rDGJeb" jsaction="sPvj8e:e4JwSe,vwKRrd;" data-required="true" data-item-id="8341804"><div class="freebirdFormviewerViewItemsItemItemHeader"><div class="freebirdFormviewerViewItemsItemItemTitleContainer"><div class="freebirdFormviewerViewItemsItemItemTitle freebirdCustomFont" dir="auto" role="heading" aria-level="2" aria-describedby="i.desc.8341804 i34">Zip <span class="freebirdFormviewerViewItemsItemRequiredAsterisk" aria-label="Required question">*</span></div><div class="freebirdFormviewerViewItemsItemItemHelpText" id="i.desc.8341804" dir="auto"></div></div></div><div class="freebirdFormviewerViewItemsTextItemWrapper"><div class="quantumWizTextinputPaperinputEl freebirdFormviewerViewItemsTextShortText freebirdThemedInput" jscontroller="pxq3x" jsaction="clickonly:KjsqPd; focus:Jt1EX; blur:fpfTEe; input:Lg5SV;" jsshadow jsname="W85ice"><div class="quantumWizTextinputPaperinputMainContent exportContent"><div class="quantumWizTextinputPaperinputContentArea exportContentArea"><div class="quantumWizTextinputPaperinputInputArea"><input type="text" class="quantumWizTextinputPaperinputInput exportInput" jsname="YPqjbf" autocomplete="off" tabindex="0" aria-label="Zip" aria-describedby="i.desc.8341804 i.err.8341804" name="entry.2065178228" value="" required dir="auto" data-initial-dir="auto" data-initial-value=""/><div jsname="LwH6nd" class="quantumWizTextinputPaperinputPlaceholder exportLabel" >Your answer</div></div><div class="quantumWizTextinputPaperinputUnderline exportUnderline"></div><div jsname="XmnwAc" class="quantumWizTextinputPaperinputFocusUnderline exportFocusUnderline"></div></div></div><div class="quantumWizTextinputPaperinputCounterErrorHolder"><div jsname="ty6ygf" class="quantumWizTextinputPaperinputHint exportHint"></div></div></div></div><div class="freebirdFormviewerViewItemsItemGradingGradingBox freebirdFormviewerViewItemsItemGradingFeedbackBox" jsname="R7fTud"></div><div jsname="XbIQze" class="freebirdFormviewerViewItemsItemErrorMessage" id="i.err.8341804" role="alert"></div></div><div role="listitem" class="freebirdFormviewerViewItemsItemItem freebirdFormviewerViewItemsTextTextItem" jsname="ibnC6b" jscontroller="rDGJeb" jsaction="sPvj8e:e4JwSe,vwKRrd;" data-item-id="1978410122"><div class="freebirdFormviewerViewItemsItemItemHeader"><div class="freebirdFormviewerViewItemsItemItemTitleContainer"><div class="freebirdFormviewerViewItemsItemItemTitle freebirdCustomFont" dir="auto" role="heading" aria-level="2" aria-describedby="i.desc.1978410122">Important information that we may need to know. Any specific instructions or notes?</div><div class="freebirdFormviewerViewItemsItemItemHelpText" id="i.desc.1978410122" dir="auto"></div></div></div><div class="quantumWizTextinputPapertextareaEl modeLight freebirdFormviewerViewItemsTextLongText freebirdThemedInput" jscontroller="pxq3x" jsaction="clickonly:KjsqPd; focus:Jt1EX; blur:fpfTEe; input:Lg5SV;" jsshadow jsname="W85ice"><div class="quantumWizTextinputPapertextareaMainContent exportContent"><div class="quantumWizTextinputPapertextareaPlaceholder exportLabel"  jsname="LwH6nd">Your answer</div><div class="quantumWizTextinputPapertextareaContentArea exportContentArea"><textarea class="quantumWizTextinputPapertextareaInput exportTextarea" jsname="YPqjbf" data-rows="1" tabindex="0" aria-label="Important information that we may need to know. Any specific instructions or notes?" jscontroller="gZjhIf" jsaction="input:Lg5SV;ti6hGc:XMgOHc;rcuQ6b:WYd;" name="entry.571926124" dir="auto" data-initial-dir="auto" data-initial-value=""></textarea></div><div class="quantumWizTextinputPapertextareaUnderline exportUnderline"></div><div jsname="XmnwAc" class="quantumWizTextinputPapertextareaFocusUnderline exportFocusUnderline"></div></div><div class="quantumWizTextinputPapertextareaCounterErrorHolder"><div jsname="ty6ygf" class="quantumWizTextinputPapertextareaHint exportHint"></div></div></div><div class="freebirdFormviewerViewItemsItemGradingGradingBox freebirdFormviewerViewItemsItemGradingFeedbackBox" jsname="R7fTud"></div><div jsname="XbIQze" class="freebirdFormviewerViewItemsItemErrorMessage" id="i.err.1978410122" role="alert"></div></div><div role="listitem" class="freebirdFormviewerViewItemsItemItem" jsname="ibnC6b" jscontroller="RGrRJf" data-item-id="717684539"><div class="freebirdMaterialHeaderbannerLabelContainer freebirdFormviewerViewItemsSectionheaderBanner" jsname="bLLMxc" role="heading"><div class="freebirdMaterialHeaderbannerLabelTextContainer freebirdSolidBackground"><div class="freebirdMaterialHeaderbannerSectionText freebirdFormviewerViewItemsSectionheaderBannerText freebirdCustomFont">Rescue Only: Please rate this emergency on a scale of 1-3</div></div><div class="freebirdMaterialHeaderbannerSectionTriangleContainer"><svg xmlns="http://www.w3.org/2000/svg" version="1.1" viewBox="0 0 10 10" preserveAspectRatio="none" class="freebirdMaterialHeaderbannerSectionTriangle"><polygon class="freebirdSolidFill" points="0,0 10,0 0,10"></polygon></svg></div></div><div class="freebirdFormviewerViewItemsSectionheaderDescriptionText">1 - life or death, submerged in water, medical emergency<br>2 - water very high, elderly, young children<br>3 - water rising, health people</div><div jsname="XbIQze" class="freebirdFormviewerViewItemsItemErrorMessage" id="i.err.717684539" role="alert"></div></div><div role="listitem" class="freebirdFormviewerViewItemsItemItem freebirdFormviewerViewItemsTextTextItem" jsname="ibnC6b" jscontroller="rDGJeb" jsaction="sPvj8e:e4JwSe,vwKRrd;" data-item-id="143999079"><div class="freebirdFormviewerViewItemsItemItemHeader"><div class="freebirdFormviewerViewItemsItemItemTitleContainer"><div class="freebirdFormviewerViewItemsItemItemTitle freebirdCustomFont" dir="auto" role="heading" aria-level="2" aria-describedby="i.desc.143999079">Name of person needing rescue</div><div class="freebirdFormviewerViewItemsItemItemHelpText" id="i.desc.143999079" dir="auto"></div></div></div><div class="freebirdFormviewerViewItemsTextItemWrapper"><div class="quantumWizTextinputPaperinputEl freebirdFormviewerViewItemsTextShortText freebirdThemedInput" jscontroller="pxq3x" jsaction="clickonly:KjsqPd; focus:Jt1EX; blur:fpfTEe; input:Lg5SV;" jsshadow jsname="W85ice"><div class="quantumWizTextinputPaperinputMainContent exportContent"><div class="quantumWizTextinputPaperinputContentArea exportContentArea"><div class="quantumWizTextinputPaperinputInputArea"><input type="text" class="quantumWizTextinputPaperinputInput exportInput" jsname="YPqjbf" autocomplete="off" tabindex="0" aria-label="Name of person needing rescue" aria-describedby="i.desc.143999079 i.err.143999079" name="entry.1945419530" value="" dir="auto" data-initial-dir="auto" data-initial-value=""/><div jsname="LwH6nd" class="quantumWizTextinputPaperinputPlaceholder exportLabel" >Your answer</div></div><div class="quantumWizTextinputPaperinputUnderline exportUnderline"></div><div jsname="XmnwAc" class="quantumWizTextinputPaperinputFocusUnderline exportFocusUnderline"></div></div></div><div class="quantumWizTextinputPaperinputCounterErrorHolder"><div jsname="ty6ygf" class="quantumWizTextinputPaperinputHint exportHint"></div></div></div></div><div class="freebirdFormviewerViewItemsItemGradingGradingBox freebirdFormviewerViewItemsItemGradingFeedbackBox" jsname="R7fTud"></div><div jsname="XbIQze" class="freebirdFormviewerViewItemsItemErrorMessage" id="i.err.143999079" role="alert"></div></div><div role="listitem" class="freebirdFormviewerViewItemsItemItem freebirdFormviewerViewItemsTextTextItem" jsname="ibnC6b" jscontroller="rDGJeb" jsaction="sPvj8e:e4JwSe,vwKRrd;" data-item-id="1283419128"><div class="freebirdFormviewerViewItemsItemItemHeader"><div class="freebirdFormviewerViewItemsItemItemTitleContainer"><div class="freebirdFormviewerViewItemsItemItemTitle freebirdCustomFont" dir="auto" role="heading" aria-level="2" aria-describedby="i.desc.1283419128">How many people?</div><div class="freebirdFormviewerViewItemsItemItemHelpText" id="i.desc.1283419128" dir="auto"></div></div></div><div class="freebirdFormviewerViewItemsTextItemWrapper"><div class="quantumWizTextinputPaperinputEl freebirdFormviewerViewItemsTextShortText freebirdThemedInput" jscontroller="pxq3x" jsaction="clickonly:KjsqPd; focus:Jt1EX; blur:fpfTEe; input:Lg5SV;" jsshadow jsname="W85ice"><div class="quantumWizTextinputPaperinputMainContent exportContent"><div class="quantumWizTextinputPaperinputContentArea exportContentArea"><div class="quantumWizTextinputPaperinputInputArea"><input type="text" class="quantumWizTextinputPaperinputInput exportInput" jsname="YPqjbf" autocomplete="off" tabindex="0" aria-label="How many people?" aria-describedby="i.desc.1283419128 i.err.1283419128" name="entry.7828510" value="" dir="auto" data-initial-dir="auto" data-initial-value=""/><div jsname="LwH6nd" class="quantumWizTextinputPaperinputPlaceholder exportLabel" >Your answer</div></div><div class="quantumWizTextinputPaperinputUnderline exportUnderline"></div><div jsname="XmnwAc" class="quantumWizTextinputPaperinputFocusUnderline exportFocusUnderline"></div></div></div><div class="quantumWizTextinputPaperinputCounterErrorHolder"><div jsname="ty6ygf" class="quantumWizTextinputPaperinputHint exportHint"></div></div></div></div><div class="freebirdFormviewerViewItemsItemGradingGradingBox freebirdFormviewerViewItemsItemGradingFeedbackBox" jsname="R7fTud"></div><div jsname="XbIQze" class="freebirdFormviewerViewItemsItemErrorMessage" id="i.err.1283419128" role="alert"></div></div><div role="listitem" class="freebirdFormviewerViewItemsItemItem freebirdFormviewerViewItemsTextTextItem" jsname="ibnC6b" jscontroller="rDGJeb" jsaction="sPvj8e:e4JwSe,vwKRrd;" data-item-id="434384562"><div class="freebirdFormviewerViewItemsItemItemHeader"><div class="freebirdFormviewerViewItemsItemItemTitleContainer"><div class="freebirdFormviewerViewItemsItemItemTitle freebirdCustomFont" dir="auto" role="heading" aria-level="2" aria-describedby="i.desc.434384562">Any medical emergencies?</div><div class="freebirdFormviewerViewItemsItemItemHelpText" id="i.desc.434384562" dir="auto"></div></div></div><div class="freebirdFormviewerViewItemsTextItemWrapper"><div class="quantumWizTextinputPaperinputEl freebirdFormviewerViewItemsTextShortText freebirdThemedInput" jscontroller="pxq3x" jsaction="clickonly:KjsqPd; focus:Jt1EX; blur:fpfTEe; input:Lg5SV;" jsshadow jsname="W85ice"><div class="quantumWizTextinputPaperinputMainContent exportContent"><div class="quantumWizTextinputPaperinputContentArea exportContentArea"><div class="quantumWizTextinputPaperinputInputArea"><input type="text" class="quantumWizTextinputPaperinputInput exportInput" jsname="YPqjbf" autocomplete="off" tabindex="0" aria-label="Any medical emergencies?" aria-describedby="i.desc.434384562 i.err.434384562" name="entry.753615407" value="" dir="auto" data-initial-dir="auto" data-initial-value=""/><div jsname="LwH6nd" class="quantumWizTextinputPaperinputPlaceholder exportLabel" >Your answer</div></div><div class="quantumWizTextinputPaperinputUnderline exportUnderline"></div><div jsname="XmnwAc" class="quantumWizTextinputPaperinputFocusUnderline exportFocusUnderline"></div></div></div><div class="quantumWizTextinputPaperinputCounterErrorHolder"><div jsname="ty6ygf" class="quantumWizTextinputPaperinputHint exportHint"></div></div></div></div><div class="freebirdFormviewerViewItemsItemGradingGradingBox freebirdFormviewerViewItemsItemGradingFeedbackBox" jsname="R7fTud"></div><div jsname="XbIQze" class="freebirdFormviewerViewItemsItemErrorMessage" id="i.err.434384562" role="alert"></div></div><div role="listitem" class="freebirdFormviewerViewItemsItemItem" jsname="ibnC6b" jscontroller="RGrRJf" data-item-id="1080546108"><div class="freebirdFormviewerViewItemsSectionheaderDescriptionText">We are a team of volunteers from across the United States working together to help Texas following Hurricane Harvey. Please note, there is a chance this request may be used by government agencies including the police, fire department, national guard, coast guard, red cross, etc. during disaster relief operations. By adding your information to this form you are consenting to this possibility. <p>You declare this request for aid to be factual and, by submitting this form, do hereby claim all responsibility for information contained herein.</p></div><div jsname="XbIQze" class="freebirdFormviewerViewItemsItemErrorMessage" id="i.err.1080546108" role="alert"></div></div></div><div class="freebirdFormviewerViewNavigationNavControls" jscontroller="lSvzH" jsaction="rcuQ6b:npT2md;JIbuQc:Gl574d(QR6bsb),V3upec(GeGHKb),HiUbje(M2UYVd),NPBnCf(OCpkoe);" data-shuffle-seed="-1081522288010436721" data-should-execute-invisible-captcha-challenge="false" data-is-receipt-checked="false"><div class="freebirdFormviewerViewNavigationButtonsAndProgress"><div class="freebirdFormviewerViewNavigationButtons"><div role="button" class="quantumWizButtonPaperbuttonEl quantumWizButtonPaperbuttonFlat quantumWizButtonPaperbuttonDark quantumWizButtonPaperbutton2El2 freebirdFormviewerViewNavigationSubmitButton" jscontroller="VXdfxd" jsaction="click:cOuCgd; mousedown:UX7yZ; mouseup:lbsD7e; mouseenter:tfO1Yc; mouseleave:JywGue;touchstart:p6p2H; touchmove:FwuNnf; touchend:yfqBxc(preventMouseEvents=true|preventDefault=true); touchcancel:JMtRjd;focus:AHmuwe; blur:O22p3e; contextmenu:mg9Pef;" jsshadow jsname="M2UYVd" aria-disabled="false" tabindex="0" ><div class="quantumWizButtonPaperbuttonRipple exportInk" jsname="ksKsZd"></div><div class="quantumWizButtonPaperbuttonFocusOverlay exportOverlay"></div><content class="quantumWizButtonPaperbuttonContent"><span class="quantumWizButtonPaperbuttonLabel exportLabel">Submit</span></content></div></div></div><div class="freebirdFormviewerViewNavigationPasswordWarning">Never submit passwords through Google Forms.</div></div><input type="hidden" name="fvv" value="1"><input type="hidden" name="draftResponse" value="[null,null,&quot;-1081522288010436721&quot;]
"><input type="hidden" name="pageHistory" value="0"><input type="hidden" name="fbzx" value="-1081522288010436721"></div></div></form><div><div class="freebirdFormviewerViewFooterDisclaimer freebirdFormviewerViewFooterNoTextDecoration freebirdDisclaimerColor">This content is neither created nor endorsed by Google. <a href="https://docs.google.com/forms/d/e/1FAIpQLScv3sJ-wuaupWKVjCTR6Oexxy1X1RzKTgpdfhT0XDTSP22b2A/reportabuse?source=https://docs.google.com/forms/d/e/1FAIpQLScv3sJ-wuaupWKVjCTR6Oexxy1X1RzKTgpdfhT0XDTSP22b2A/viewform">Report Abuse</a> - <a href="http://www.google.com/accounts/TOS">Terms of Service</a> - <a href="http://www.google.com/google-d-s/terms.html">Additional Terms</a></div><div class="freebirdFormviewerViewFooterImageContainer freebirdFormviewerViewFooterPageBreak"><a dir="auto" href="//www.google.com/forms/about/?utm_source=product&utm_medium=forms_logo&utm_campaign=forms"><img src="https://www.gstatic.com/images/branding/googlelogo/svg/googlelogo_dark_clr_74x24px.svg" alt="Google" height="24px" width="74px"/>&nbsp;<span class="freebirdCommonViewProductnameLockupText">Forms</span></a></div></div></div><div jscontroller="KFVhZe" jsaction="JIbuQc:feqbab" class="freebirdFormviewerViewFeedbackSubmitFeedbackButton"><div role="button" class="quantumWizButtonPapericonbuttonEl quantumWizButtonPapericonbuttonLight" jscontroller="VXdfxd" jsaction="click:cOuCgd; mousedown:UX7yZ; mouseup:lbsD7e; mouseenter:tfO1Yc; mouseleave:JywGue;touchstart:p6p2H; touchmove:FwuNnf; touchend:yfqBxc(preventMouseEvents=true|preventDefault=true); touchcancel:JMtRjd;focus:AHmuwe; blur:O22p3e; contextmenu:mg9Pef;" jsshadow jsname="hlkvRb" aria-label="Report a problem to Google" aria-disabled="false" tabindex="0" data-tooltip="Report a problem to Google" data-tooltip-position="right" data-tooltip-vertical-offset="1"  data-tooltip-vertical-offset="-12" data-tooltip-horizontal-offset="0"><div class="quantumWizButtonPapericonbuttonRipple exportInk" jsname="ksKsZd"></div><content class="quantumWizButtonPapericonbuttonContent"><span style="top: -12px"><div class="freebirdMaterialIconIconEl"><div class="freebirdMaterialIconIconImage freebirdMaterialIconIconDarkIcon freebird-qp-icon-feedback-b" aria-hidden="true">&nbsp;</div><div class="freebirdMaterialIconIconImage freebirdMaterialIconIconLightIcon freebird-qp-icon-feedback-w" aria-hidden="true">&nbsp;</div></div></span></content></div></div></div><script type="text/javascript">var FB_PUBLIC_LOAD_DATA_ = [null,["If you need assistance, please complete this form. BE AS THOROUGH AS POSSIBLE.\nOn September 4th, we updated our rescue (this) form as our team begins to transition from rescue operations into wellness and relief. If you have an emergency situation and need to be rescued, we recommend you still complete this form, text RESCUE to 33222, and call 911.\n\nFacebook group: https://www.facebook.com/groups/831235773703488/\nFacebook page: https://www.facebook.com/HHVolunteerRescue/ \n",[[537216565,"Request type",null,2,[[510224880,[["Wellness Check",null,null,null,0]
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