It seems pretty damn intrusive overall.
Should be pretty simple if theres an emergency in your congregation shouldn't it? Your name, address and phone number, your personal stock of supplies from your checklist and a simple case of 'yes' I have made alternate arrangements in case of emergency or 'no - I need help' in case of emergency. That 'request for help' box should indicate that all of those on that list, will meet at the KH for safety and further action and/or direction. You know - your 'friends' helping out their 'friends'.
The idea that you have to give all the names and numbers of the families you will be going to is a pile of crud. All it does is give them a straight line to finding you and dragging you back or at the very least, calling the Elders of the congregation in the area you fled to. A better way to keep tabs on you. It also provides them with more names to quiz you on - are they 'believers', how do you know them, are they opent o a book study...the list goes on.
Fear, guilt, intrusion - fear, guilt, intrusion - fear...guilt....intrusion....fear...fear....fear....fear....fear......sammieswife.