COVID-19 Long Beach Block Volunteer Form

Please fill out the form below to volunteer with We Love LB during the COVID-19 pandemic. You must read and agree to the below statements as well as sign & email back the Volunteer Waiver Form linked below. We will be in touch once we have received the waiver from you. Thank you!









8am-12pm2pm-5pmAll of the above


YesNo

Please fill out the form below to volunteer with We Love LB during the COVID-19 pandemic. You must read and agree to the below statements as well as sign & email back the Volunteer Waiver Form linked below. We will be in touch once we have received the waiver from you. Thank you!

As a volunteer I agree to abide to the following:

  • Wash or sanitize my hands thoroughly before I distribute any kits or products to neighbors
  • I will wear gloves while I volunteer.
  • Step away and stand at least 6 feet away from your neighbor’s door after knocking.
  • If your neighbor answers the door, introduce yourself, ask how they’re doing, and let them know you will be leaving their kit outside the door for them to grab after you walk away.
  • Please advise that you do not volunteer if you have travelled to any countries within the last fourteen days for which the Centers for Disease Control has issued Level Two or Level Three travel health notices, including: China, Italy, Iran, Japan, and South Korea.
  • Please advise that you do not volunteer if you reside or have had close contact with someone who has travelled to one of those countries within the last fourteen days;
  • Please advise that you do not volunteer if you have been asked to self-quarantine by any doctor, hospital, or health agency;
  • Please advise that you do not volunteer if you have been diagnosed with, or have had contact with, anyone who has been diagnosed with the coronavirus; and
  • Please advise that you do not volunteer if you have any apparent symptoms of COVID-19, such as, fever, severe cough, or shortness of breath.
  • Please advise that you do not volunteer if you are an older adult or person with severe underlying chronic medical conditions such as heart or lung disease or diabetes, which seem to be at higher risk for developing more serious complications from COVID-19 illness.
  • Refer to the CDC website for more information: https://www.cdc.gov/coronavirus/2019-ncov/

    If yes to all of the above, click "Yes, I agree", and check your email for our waiver.
    Yes, I agree