The version of the browser you are using is no longer supported. Please upgrade to a supported browser.Dismiss

Send
Section 1 of 1
Service Without Walls Waiver & Serving Signup
Submit one (1) Volunteer Waiver per Adult (Over 18)
or Family (married only) unmarried couples must use separate forms per adult
Email
This form is collecting emails.Change settings
First and Last Name
Question Type
Loading image…
Answer key
(0 points)
Loading...
Loading…
Phone Number
Question Type
Loading image…
Answer key
(0 points)
Loading...
Loading…
Permission to add your number/email to our volunteer database.
Question Type
Loading image…
Yes both
Phone number only
Email only
No neither
Add option
or
add "Other"
Answer key
(0 points)
Loading...
Loading…
Participant(s) acknowledge that they are voluntarily participating in a charitable event/service to serve people experiencing homelessness and others in need sponsored/partnered by Service Without Walls, Inc.
Participant(s) also acknowledge that such events may take place in areas within the city limits of Atlanta and/or in other challenged neighborhoods and that such voluntary participation has the potential risk of being exposed to criminal activity which may result in the loss of property of or personal injury to Participant(s). Participant(s) acknowledge that there is a continuing Pandemic (COVID-19) in addition to other diseases that can be communicated or transmitted in group settings. Participant(s) agree to wear masks if/when required and/or necessary for medical safety for self-and/or others, socially distance and/or otherwise follow CDC guidelines while participating in/with Service Without Walls sponsored/partnered charitable events/services. 
Participant(s) fully assume(s) the risks associated with the participation in the event(s) by being present and/or participation in these events. In addition, volunteers, servers and/or participants do hereby agree to hold harmless, not file suit and promise to indemnify, Service Without Walls, Inc., its officers, directors, owners and/or agents from any and all claims, demands, causes of action and other liabilities that may arise while: serving, visiting, participating, in route to or from a sponsored/partner event. 
Participation and presence at our sponsored/partner events also indicate your approval for you and any minor(s)/dependent(s) to be pictured in video, photographs and likeness by Service Without Walls, Inc. and may be used on promotional and/or other materials, websites and/or social media sites as allowed by Service Without Walls. This agreement will remain in effect from the date signed/submitted for every time you volunteer/participate until revoked in writing. You may be asked to submit or sign a new agreement each year or when changes are made but this signed document remains in effect until it is replaced or revoked in writing.
Question Type
Loading image…
1.
I Agree for myself (Adult)
2.
I Agree for myself and minor child/children
3.
I Agree for my minor child/children sent with a Designated Responsible Adult (Please be sure to list child children as well as the DRA) in the appropriate lines below
4.
We agree as a married couple (Husband & Wife)
5.
We agree as a married couple (Husband & Wife) & minor child/children. (Please List ALL names in the appropriate lines)
6.
Add option
Answer key
(0 points)
Loading...
Loading…
Name(s) Minor Children 
***Enter DNA if it Does Not Apply***
Question Type
Loading image…
Answer key
(0 points)
Loading...
Loading…
Name(s) of Designated Responsible Adult(s) if parent/legal guardian will not be present.
(DRA Must be over 18 AND at least 6 years older than child)* 
(must be completed by parent or legal guardian only) *Both MUST Sign in signature area* 
***Enter DNA if it Does Not Apply***
Question Type
Loading image…
Answer key
(0 points)
Loading...
Loading…
Name of Parent/Legal Guardian assigning the above Designated Responsible Adult (Print) 
**Required if there is an assigned Designated Responsible Adult** 
***Enter DNA if it Does Not Apply***
Question Type
Loading image…
Answer key
(0 points)
Loading...
Loading…
I would like to sign up to serve the following Saturday(s)
***If it is within 48 hours of a date you would like to attend, please call 770-954-5378 after submitting your Waiver/Request.
Question Type
Loading image…
Saturday, January 20, 2024
Saturday, February 17th, 2024
Saturday, March 16th, 2024
Saturday, April 20th, 2024
Saturday, May 18th, 2024
Saturday, June 15th, 2024
Saturday, July 20th, 2024
Saturday, August 17th, 2024
Saturday, September 21st, 2024
Saturday, October 19th, 2024
Saturday, November 16th, 2024
Saturday, December 21st, 2024
Saturday, January 18th, 2025
Add option
or
add "Other"
Answer key
(0 points)
Loading...
Loading…
You agree you will arrive to serve per your selected date above and time below.
Question Type
Loading image…
Yes, I will arrive at 10:30am and stay until 3pm
I will arrive at 10:30am but I must leave before 3pm (Please enter leave time in other)
I will arrive after 10:30am, but I will stay until 3pm (Please enter arrival time in other)
I will arrive after 10:30 am and must leave before 3pm (Please enter arrival & departure time in other)
Other…
Add option
Answer key
(0 points)
Loading...
Loading…
If you are unable to serve on a day you requested and are signed up to serve; you will provide notice to allow others to serve and so that we are short-handed in servers.
Question Type
Loading image…
1.
Yes
2.
No
3.
Add option
Answer key
(0 points)
Loading...
Loading…
Submitting this form represents your agreement to these terms and conditions and you agree that your responses are true and correct. Please type name in other area
Question Type
Loading image…
YES
No
Other…
Add option
Answer key
(0 points)
Loading...
Loading…
Please Type Name Here representing your digital signature. 
Sign here if a paper copy

Question Type
Loading image…
Answer key
(0 points)
Loading...
Loading…
Link to Sheets
Message for respondents
This form is no longer accepting responses
Insights
Total points distribution
Loading...
Loading responses…
First and Last Name
No responses yet for this question.
Phone Number
Copy
No responses yet for this question.
Permission to add your number/email to our volunteer database.
Copy
No responses yet for this question.
Participant(s) acknowledge that they are voluntarily participating in a charitable event/service to serve people experiencing homelessness and others in need sponsored/partnered by Service Without Walls, Inc.
Participant(s) also acknowledge that such events may take place in areas within the city limits of Atlanta and/or in other challenged neighborhoods and that such voluntary participation has the potential risk of being exposed to criminal activity which may result in the loss of property of or personal injury to Participant(s). Participant(s) acknowledge that there is a continuing Pandemic (COVID-19) in addition to other diseases that can be communicated or transmitted in group settings. Participant(s) agree to wear masks if/when required and/or necessary for medical safety for self-and/or others, socially distance and/or otherwise follow CDC guidelines while participating in/with Service Without Walls sponsored/partnered charitable events/services. 
Participant(s) fully assume(s) the risks associated with the participation in the event(s) by being present and/or participation in these events. In addition, volunteers, servers and/or participants do hereby agree to hold harmless, not file suit and promise to indemnify, Service Without Walls, Inc., its officers, directors, owners and/or agents from any and all claims, demands, causes of action and other liabilities that may arise while: serving, visiting, participating, in route to or from a sponsored/partner event. 
Participation and presence at our sponsored/partner events also indicate your approval for you and any minor(s)/dependent(s) to be pictured in video, photographs and likeness by Service Without Walls, Inc. and may be used on promotional and/or other materials, websites and/or social media sites as allowed by Service Without Walls. This agreement will remain in effect from the date signed/submitted for every time you volunteer/participate until revoked in writing. You may be asked to submit or sign a new agreement each year or when changes are made but this signed document remains in effect until it is replaced or revoked in writing.
Copy
No responses yet for this question.
Name(s) Minor Children 
***Enter DNA if it Does Not Apply***
No responses yet for this question.
Name(s) of Designated Responsible Adult(s) if parent/legal guardian will not be present.
(DRA Must be over 18 AND at least 6 years older than child)* 
(must be completed by parent or legal guardian only) *Both MUST Sign in signature area* 
***Enter DNA if it Does Not Apply***
No responses yet for this question.
Name of Parent/Legal Guardian assigning the above Designated Responsible Adult (Print) 
**Required if there is an assigned Designated Responsible Adult** 
***Enter DNA if it Does Not Apply***
No responses yet for this question.
I would like to sign up to serve the following Saturday(s)
***If it is within 48 hours of a date you would like to attend, please call 770-954-5378 after submitting your Waiver/Request.
Copy
No responses yet for this question.
You agree you will arrive to serve per your selected date above and time below.
Copy
No responses yet for this question.
If you are unable to serve on a day you requested and are signed up to serve; you will provide notice to allow others to serve and so that we are short-handed in servers.
Copy
No responses yet for this question.
Submitting this form represents your agreement to these terms and conditions and you agree that your responses are true and correct. Please type name in other area
Copy
No responses yet for this question.
Please Type Name Here representing your digital signature. 
Sign here if a paper copy

Copy
No responses yet for this question.
Settings
Responses
Manage how responses are collected and protected
Presentation
Manage how the form and responses are presented
Defaults
Form defaults
Settings applied to this form and new forms
Question defaults
Settings applied to all new questions
.