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Adopt A Neighbor Request Form - COVID-19 Response

Get Help from a Neighbor Volunteer - COVID-19 Response

Fill out this form to request help from a neighbor volunteer through this uniquely challenging time. We are looking for neighbors in Fort Collins and the surrounding Growth Management Area who are vulnerable to COVID-19 and need assistance with daily tasks.  You will be paired with a volunteer in your community!  Tasks may include but are not limited to grocery shopping and delivery, basic errands, driveway shoveling, pet care and more. You will:  

  • Be connected with a neighbor who wants to help and is background checked and trained by the City of Fort Collins on COVID-19 safety.  

  • Develop a list of tasks that would help you be more comfortable to be completed by the volunteer neighbor. 

  • Assign volunteer neighbor errands or tasks to help you. 

Important Notes:
Volunteers are not permitted inside your home. All tasks must take place outside.
We will attempt to accommodate every request if possible but cannot guarantee it.


If this message reaches anyone who would like to volunteer to help, please fill out this application to be paired with a neighbor in need https://engage.fcgov.com/d/HR/App/AdoptANeighbor
 

9. How do you prefer to be contacted by a volunteer neighbor? *This question is required.
10. What kind of tasks would you like help with?  *This question is required.
11. Do you have person living with you that can complete the task you are needing help with? *This question is required.
12. What length of time do you anticipate needing help from a neighbor?
13.  

The City of Fort Collins provides a Restorative Justice program to youth ages 14-21 who are required to complete a set number of volunteer hours via court mandate. The restorative justice program brings people together to identify the harm caused by a criminal incident and to find ways to repair that harm.    

In some cases we will pair two volunteers to work together for one resident in need. This may include a volunteer from the restorative justice program. If you are interested in this option please check this box.

*This question is required.

RESIDENT CONSENT, RELEASE OF LIABILITY, COVENANT NOT TO SUE, AND HOLD HARMLESS

I hereby request placement as a recipient in the Adopt-A-Neighbor Program ("Program"). I understand that volunteers will not be allowed to enter my home.

I hereby release the City of Fort Collins, its officers, employees, volunteers, and agents (collectively, "Releasees") from any and all liability for any and all claims and causes of action which I may hereafter have on account of any and all injuries and damage to me or my property, or loss of any other sort, arising out of or relating to my participation as a recipient in the Program and the services provided to me, or incidental thereto, whether caused by the negligence of the Releasees or any other person. In addition, I covenant and agree not to sue any of the Releasees, and agree to forever hold them and each of them harmless from any liability, claims, demands, actions, or causes of action whatsoever arising from my participation as a recipient in the Program and the services provided to me, whether such liability, claims, demands, or actions are the result of the negligence of the Releasees or any other person. This release of liability, covenant not to sue, hold harmless agreement shall be binding upon me and my heirs, executors, administrators, personal representatives, and assigns, and shall inure to the benefit of the Releasees and their successors and assigns.

15. I agree to the guidelines above and wish to participate in the Adopt A Neighbor program. *This question is required.
This question requires a valid date format of MM/DD/YYYY.
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