Housing Program Accommodation Agreement & Liability Release

In order to be granted housing at A Shelter for Cancer Families, the responsible party of the family must submit acknowledgement of the following agreement.  This confirms understanding and agreement with the stipulations set forth in our Housing Policy.  (This does NOT need to be submitted until you have received an email from our housing team confirming availability.)

Do you understand English

Please read, acknowledge your understanding of, and agreement to, the conditions of your stay with ASCF for temporary housing. By accepting, you are acknowledging that you understand and agree to all of the ASCF Housing Policy, Guest Liability and Indemnification Release, and Media Release statements on this waiver. Furthermore, you understand that agreement to the conditions set forth also applies to all Guests (the patient and all members of the patient's party including caregivers, family members, and guests). 

HOUSING POLICY & GUEST LIABILITY AND INDEMNIFICATION

By accepting the following conditions, you are releasing ASCF of liability. The responsible party for himself, herself or themselves, and on behalf of any guests you invite on campus and on behalf of the said minors, hereby remises and releases and forever discharges ASCF, its Directors, Staff and/or Volunteers to whom this release is addressed. 
 

The responsible party releases each member and every director or similar fiduciary thereof and their respective officers, agents and/or employees from any and all demands, actions, causes of actions, suits, claims and/or liabilities whatsoever arising out of or in connection with any event, occurrence or incident set forth in the preceding paragraph whether caused by the negligence of any of the parties so released or otherwise. 
 

The responsible party hereby further agrees to indemnify, hold harmless and defend any and all of the said addresses against any and all such claims or liabilities asserted against them or any of them by third persons by reasons of any acts or omissions of the primary applicant or his or her minor children or animals occurring during the period that the said accommodations are being furnished. 

ACKNOWLEDGEMENT OF ASCF HOUSING POLICY

Guests are required to comply with all laws set forth by our local, state, and federal government. Each patient, caregiver, family member, and guest housed by ASCF must also agree to adhere to all ASCF’s policies and procedures governing the property. Guests who fail to adhere to these laws, policies or procedures are subject to immediate dismissal from the property and may become ineligible for future housing assistance. Failure to comply with a dismissal from the property will result in such person being guilty of trespass. 

All Guests must be a U.S. citizen or have permanent legal residency in the United States or a U.S. territory. 

ASCF provides free short-term housing for a maximum of 8 weeks. Compassionate extensions may be granted on a case by case basis. 

ASCF cannot accommodate individuals who will be traveling unaccompanied and are unable to provide self-care. 

The Responsible Party must notify ASCF no less than 24 hours prior to any absence during an approved stay. If Guests are absent for more than 3 days in a seven-day period without prior ASCF approval, the reservation will be cancelled, and the Responsible Party will need to re-apply for a new stay period.

A security deposit in the amount of $250 is required to be paid one week prior to the anticipated date of arrival for each housing reservation. A $100 cleaning fee will be withheld from each security deposit. The remainder of the security deposit ($150) can be donated to ASCF to help future cancer families or refunded provided that the property, residence, and its contents are in the same condition as at check-in, all keys have been returned, and any applicable borrowed items have been left in the residence. 

The Responsible Party is responsible and will be held financially liable for the actions and/or behavior of all Guests while on ASCF premises.

No Smoking, No Tobacco or Pets - It is important to provide a clean, allergen-free environment for patients. The residences and property are subject to a strict no smoking, no tobacco and no pets (of any kind) policy. Only service dogs required by law are excluded from this policy.

The Responsible Party must confirm their departure date upon check-in and again 3 days prior to the departure date. In the event of an early departure, the Responsible Party must give advance notice of the new departure date. The Responsible Party may also submit a request for an extension to their stay (not to exceed the 8-week maximum). Extensions of stays are based upon availability and are not guaranteed.

Any guest that uses the pool on premise acknowledges that there is NO DIVING. Swimmers swim at your own risk as there is no lifeguard on duty. 

ASCF is not responsible for lost, damaged, left-behind, or stolen items in your residence or automobile. ASCF is also not liable for injuries suffered or for accidents on the premises. In the event of an incident, a report must be filed with ASCF.

Any person who, in the sole opinion of ASCF has been, or is likely in the future to be disruptive or harmful to other Guests, the operation of the residence, or the environment must vacate the premises immediately upon the request of ASCF and failure to do so will result in such person/s being guilty of trespass. Those considered trespassing will forfeit their deposit.

ASCF reserves the right to enter any residence with proper notice. 

ASCF reserves the right to modify this policy at any time without notice.

I hereby grant A Shelter for Cancer Families (ASCF) permission to use my likeness or anyone in my party in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications and social media without payment or other consideration.