Claremont Fresh Grocery Delivery Request
Claremont Fresh is offering a service to match low-risk members of the community to people who need help with grocery delivery or running errands in Claremont, CA and nearby cities.

When you sign up, you will be matched with a local Claremont resident who is at low risk for developing the COVID 19 virus and will help you with grocery delivery. Once your match is made, your contact information will be provided to your match and you will also be given the contact information of your match alongside other important information.

We require that the CDC & government regulations be followed for the safety and well-being of all members of our community.

You must fill out all questions of the form with complete honesty. Failure to do so will result in immediate cancellation of service offerings to you and a report to local police.

After you have completed the form, we will contact you as soon as we have found a match! For any further questions email: claremontfresh@gmail.com
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First and Last name *
Age Range *
Reason for needing Grocery Delivery *
What is your preferred grocery store *
Email address *
Phone Number *
Preferred method of communication *
Home Address *
Preferred payment method *
Do you agree to have your contact information (phone or email only, your address will not be given out) shared with one individual who is will serve as your buddy? * *
By selecting I agree below, I agree that I would like to be contacted by Claremont Fresh and/or be contacted by my match directly. I also certify that I have answered all questions truthfully and agree that failure to do so will result in the dismissal of my request and the immediate involvement of law enforcement. By clicking "I agree" below I accept all risk and responsibility and further hold any facilitator associated with Claremont Fresh harmless. I agree to follow Claremont Fresh Safety Protocols and all rules and orders of government health authorities and the CDC. I understand that Claremont Fresh will try to find a match to the best of their abilities but there is no guarantee a match will be found immediately. I also understand that Claremont Fresh members are not healthcare professionals. If I need medical advice, I will call my physician or 911. *
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