Volunteer Check-in & Waiver Form 2024

Sidewalk Hope

Volunteer Check-In & Waiver Form 2024
Today's Volunteer Date:*
Name*

First NameLast Name
Phone Number*
Email
example@example.com
Please answer each question:
Have you, or any children brought with you today, had a fever (100.4 degrees or higher) in the past 24 hours?*

YesNo
Have you (or any children brought with you today) experienced any of the following symptoms in the past 48 hours? Check all symptoms that are a "Yes."*

CoughShortness of BreathUnusual FatigueMuscle or Body AchesHeadacheNew Loss of Taste or SmellSore ThroatCongestion or Runny NoseNausea or VomitingDiarrheaI HAVE EXPERIENCED NONE OF THE ABOVE SYMPTOMS
Have you tested positive or been diagnosed with any type of viral illness within the past 10 days?*

YesNo
I understand the following: Sidewalk Hope does not require volunteers to have specific vaccinations or to be tested in order to serve as a volunteer. Wearing personal protection masks is optional unless recommended under CDC guidelines for specific circumstances, or if community levels of infection indicate higher safety measures are appropriate. Sidewalk Hope does provide masks for anyone who desires to wear one. I understand I am responsible to follow appropriate safety protocols to prevent the spread of illness while volunteering with Sidewalk Hope.

If I bring minor children (under the age of 18) to volunteer with Sidewalk Hope, I acknowledge and agree they are to be under my constant watch, care, and supervision while working as volunteers.

I understand certain risks may be involved in this type of volunteer work and I voluntarily agree to assume those risks and accept sole responsibility for any injury or illness to myself or my child(ren) that may be experienced or incurred in connection with our voluntary attendance as a Sidewalk Hope volunteer.

I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL PROVISIONS OF THIS RELEASE, AND FREELY AND KNOWINGLY ASSUME THE RISK AND WAIVE MY RIGHTS CONCERNING LIABILITY AS DESCRIBED ABOVE.
Signature*
IF YOU HAVE BROUGHT MINOR CHILDREN WITH YOU:

I am the parent or legal guardian of the minor children named below who are attending volunteer activities under my care and supervision today. I have the legal right to consent to and, by my signature above, I do hereby consent to the terms and conditions of this Waiver on their behalf.
Child's Name: First Name Last Name
Child's Name: First Name Last Name
Child's Name: First Name Last Name
Child's Name: First Name Last Name
Should be Empty:

Sidewalk Hope

Please answer each question: