2020 Survivors Speak Partner Acceptance and Registration Form (Page 2)

Registration Page 2: Release waivers and W-9 upload

You’re almost there! To complete registration, you must sign our transportation and media waivers and upload your completed W-9.

Opting out

Transportation release: If you don’t wish to to sign the transportation waiver, Crime Survivors for Safety and Justice and Alliance for Safety will not be responsible for any aspects of your travel to or from Survivors Speak. In some instances, approval to participate in any event may be withdrawn.

Media recording and photographing waiver: Photographers at Survivors Speak are trauma-informed and do not take photos without consent. Further, we don’t publish photos without consent. Signing this waiver allows our photographers to shoot freely at Survivors Speak, within reason, to capture the mood and essence of the event. If you don’t wish to to sign the release, Crime Survivors for Safety and Justice and Alliance for Safety may withdraw approval to participate in your event.

Your W-9 Upload

All 2020 partners are required to submit a completed W-9 form to receive payment for their awards. Please complete a W-9 form, which you can download here.

Scan and submit the form to our online portal on this page. Partners that do not submit a completed W-9 do not receive payment and their partnership and attendance at Survivors Speak may be withdrawn.


At Crime Survivors for Safety and Justice we believe in safety and transparency: if anything on this page or page one of your registration makes you feel uncomfortable or generates a question, ask! Write us at [email protected] and we’ll be sure to answer your question and ease your worries as quickly as we can.


1. Release of Liability for Transportation



2. Release for Media Recording and Photographing



3. Request for Taxpayer Identification Number and Certification

Please complete a W-9 form (PDF, JPG, or PNG) and upload it here.





Contact Us

1624 Franklin Avenue
11th Floor
Oakland, CA 94612

Tel: (510) 836-4700
Fax: (510) 836-4701