East for East: COVID-19 Community Assistance
Volunteer Registration Form
Name *
Email *
Facebook URL
We just need to make sure you're real person!
Mobile Number
Location/Area *
Select areas you can provide support. *
How can you help?
Do you have access to a vehicle? *
How flexible is your volunteering time? *
What times are you (generally) able to help? *
How much-turn around time might you need for a task? (General Responsiveness if Needed)
Do you have any specialist skills that may be useful? (always love to know!)
Additional Notes, Comments, etc.
Liability Waiver (the Logical but Serious Stuff) *
As you know, East for East is a volunteer community group designed to connect members of the community in this time of need. We're here to try and help each other out. On this basis, East For East will provide no distinct medical guidance and will rely on each individual volunteer to access their best judgment in taking the preventative and precautionary measures they see fit for each individual volunteer situation and as suggested by relevant government and medical authorities. By completing this form and selecting yes, you are forming an agreement to hold harmless and indemnify East From East from all liabilities, losses, claims, judgments, suits, fines, penalties, demands or expenses arising from individual participation in this community volunteer program and agree that you acknowledge and accept the inherent level of risk (both at the time of agreement and in the potential future) in volunteering and as such, willingly accept this risk.
Confidentiality Agreement *
I, the undersigned, in the course of volunteering with East For East, hereby acknowledge and agree to the following: I shall not, at any time or subsequent to this participation, make unauthorized disclosures or unauthorized use of any information that is considered confidential or proprietary. Examples: names, addresses, phone numbers of the requester. I will also not make further contact or communication with the requester once the delivery is complete. *
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