Back To School | Tears of a Mother's Cry

Mother's Name*

First Last

Email*

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Cellular Phone*

Address*

Street Address Address Line 2 City State ZIP Code

How many children will you bring?

How many of these children are elementary school students?

How many of these children are middle school students?

How many of these children are high school students?

Share your story.

COVID-19 Waiver*

I agree to the COVID-19 waiver.

The coronavirus, COVID-19, has been declared a world-wide pandemic and is believed to spread mainly from person-to-person contact.

The Tears of a Mother’s Cry (“ToaMC”) is aware of the dangers of COVID-19 and will be following the social distancing guidelines recommended by the World Health Organization (“WHO”); however, ToaMC cannot guarantee that participants will not become infected with COVID-19. We are requesting that attendees pull up to receive their Thanksgiving basket in a car and have minimal contact as volunteers place goods in their trunk.

By signing this agreement, you represent with the best of your knowledge and belief that you do not currently have COVID-19 or symptoms of COVID-19 (such as sore throat, fever, difficulty breathing, etc.) and that you have not been exposed to someone with COVID-19 within the past fourteen (14) days.

By signing this agreement, you acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that you may be exposed to or infected by COVID-19 by attending the ToaMC event and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death.

I voluntarily sign this waiver and hold harmless ToaMC.