Let us help you. firstname.lastname@example.org Name * First Name Last Name Email * Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Please Specify the items you need. Please limit to 15 items. * What stores would you like these items to be purchased from? Due to current overwhelming demand, I will limit ordering through Fierce Helpers to once per week. * I agree I understand that, although delivery through Fierce Helpers drastically decreases the risk of contracting COVID-19, it does not completely eliminate all risk. * I agree I hereby release, indemnify, defend and hold harmless Fierce Helpers, its founders and other organizers, from and against any and all claims, causes of action and liability arising from or in any way connected with my volunteer participation with Fierce Helpers, including as the same may result of coming into contact with and/or the spread of the COVID-19 Virus. * I agree What is your preferred method of payment? * Cash upon delivery Paypal Venmo Comments Thank you!