New Guest Form
We want every guest to have a positive experience at WayStation which is why we need your
agreement on the following guidelines in order to provide an orderly, productive, and positive
environment.
1. I agree not to bring weapons into the facility. A complete list of weapons is available at the
reception desk.
2. I agree to refrain from using threatening or abusive language and behaviors towards other
guests, staff, and volunteers. Such behaviors include intimidation, slapping, hitting, spitting,
pushing, throwing objects, or other behaviors which create an unsafe environment for our
guests.
3. I agree to refrain from using discriminatory speech that targets race, ethnicity, national
origin, sexual orientation, gender, gender identity, religious affiliation, age, and disability.
4. I agree to care for and treat WayStation property with respect.
5. I understand WayStation is not responsible for any stolen items while on the premises,
including personal items in an assigned locker.
6. I understand that if I leave WayStation without clearing out my locker, WayStation staff is
required to clear it out and hold it for 3 days. After, the items will be donated.
7. I agree to comply with federal, state, and local laws while on WayStation property.
8. I agree to smoke in WayStation’s outdoor designated smoking area only.
9. I agree to keep WayStation drug and alcohol free.
10. I understand I am solely responsible for my children at all times.
11. I understand staff are not allowed to transport guests in their vehicles.
12. I understand that my presence on WayStation property outside of operating hours could
constitute trespassing. Guests are allowed on the property when we are open. Our hours of
operation are 8:30 a.m. to 4 p.m., Monday through Friday and we are closed for all federal
holidays. We appreciate your cooperation.
13. I understand that failure to comply with WayStation policy, procedures, or staff’s
instruction, could result in denial of services.
14. I agree to indemnify and hold harmless WayStation and Micah 6:8 Initiative staff,
volunteers and board of directors for any loss, harm or injury resulting from use of
WayStation and its services.
15. I agree to respect the confidentiality of other guests by refraining from taking video or
photo of other guests while on WayStation premises.

I want to use WayStation services and agree and have read and had the chance to ask
questions about all of the above, and I agree to abide by these guidelines.
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Optional Photo Release: I consent and authorize WayStation and Micah 6:8
Initiative to use my likeness in any photograph, video, or other digital (photos) taken
at WayStation or any of its events in any and all of its publications, including print,
social media, or video. I irrevocably authorize WayStation and Micah 6:8 Initiative to
copy, edit, enhance, crop, or otherwise alter any photo to use in publications. I also
waive any right for approval or inspection of any photo or video. I understand and
agree that all photos or videos are the property of WayStation and Micah 6:8
Initiative and are not entitled to me. I understand and acknowledge that I am not
entitled to any compensation or royalties with respect to the use of the photo or
video.
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First Name *
Last Name *
Last four of my SSN *
What is your phone number?
*
Date of Birth
*
MM
/
DD
/
YYYY
Enter your email address. *
Are you a veteran?
*
What is your race?
*
How many other family members came with you today? (Spouse, children, etc.)
*
Will you be eating breakfast at WayStation today?
*
Will you be eating lunch at WayStation today?
*
Will you be doing laundry today?
*
Do you need a bicycle?
*
I found out about WayStation...
*
Required
Over the last few nights, I have been...
*
If you answered the above "Sleeping in my home,"
I consider myself homeless because...
Of all of the services that WayStation can offer me, I am interested in these
*
Required
I need this service that wasn't mentioned above
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