Enter to Win Dinner for 2 at Catfish Louie's and/or a Pitboss Grill!!!

These questions about home fires help Fallen Heroes & Shriners Hospitals!

Simply complete this quick questionnaire. If you win, you will be contacted by Lone Star Home Safety only, your information will not be sold to anyone.

Question Title

* 1. How often do you change the batteries in your smoke detectors?

Every 6 Months

Every Year

When they Beep

Don't have Smoke Detectors

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* 2. In case of a home fire, Have you practiced an escape plan with everyone in your home?

YES

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* 3. Have you or someone you know ever been affected by a Home Fire?

YES

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* 4. Do you own or rent your home?

OWN

RENT

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* 5. What is your marital status?

Married

Single

Living together

Widowed or Widower

Living with family

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* 6. Do you currently have kids and/or pets at home?

Kids

Pets

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* 7. What age group are you?

Under 25

25-45

46-60

60-74

75+

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* 8. Contact Information (only used if you are selected as a winner)

First & Last Name

Home Address

City

Phone Number

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* 9. Do you agree to the terms and conditions?

Yes