Guardian Angels Second Themed Dinner Event!!!
December 13th, 2019
5PM-9PM
POSTPONED
December 27TH, 2019
Please fill out the form below. Once completed you will recieve a ticket within 7 Business days to bring with you to the event.
Please fill in the application below:
Applicant (Cardholder if different) acknowledges and accepts full responsibility and guarantees payment for all services requested by me or on my behalf, either verbally or in writing, whether or not such services are authorized by Applicant, (or Cardholder if different). Applicant (or Cardholder if different) agrees that Guardian Angels Sitting Service Southern NJ (“Agency”) may pursue all avenues of collection, including use of collection agencies, and authorizes Agency to prepare and submit credit card charges using any of the charge cards listed above to recover all charges and all other unpaid amounts due including those for failure to pay on time for services rendered through membership, damages for returned check charges in the amount of $30.00 per check, and cancellation fees.
I, Applicant, give my permission for this information about my family and my children to be shared with babysitters that may be caring for my children. I, Applicant understand that the Agency is not responsible for any damage, theft, or negligence that may occur as a result of having a sitter care for my children. I understand that the Agency performs background checks based on the information that the sitter provides to Agency. The Agency is not responsible if the sitter does not provide accurate and true information and is not responsible for any history that may not come up when the background check is completed. I have read and understand that there is a 24-hour cancellation notice required or a cancellation fee in the amount of the 4-hour minimum for both the Agency and the sitter will apply. The undersigned represents that he or she has read and fully understands that this document is a release of liability.
RELEASE OF LIABILITY AND INDEMNIFICATION Applicant releases and forever discharges Guardian Angels Sitting Service Southern NJ ("Agency") and their officers, directors, agents, (collectively, the “Released Parties”) from any and all actions, costs, suits, demands, claims, damages, losses and liabilities (including reasonable attorney fees) of any type or kind whatsoever occurring from or connected with the issuance, receipt, or use of such Information by Agency and agrees to indemnify, defend, and hold harmless the Released Parties from and against any and all demands, claims, damages to persons, losses and liabilities (including reasonable attorney fees), arising out of, caused by, resulting from, or in any way related to the issuance, receipt, or use of such information.
ADDITIONAL TERMS AND CONDITIONS
No Waiver of Breach and Entire Agreement. TIME IS OF THE ESSENCE IN THIS AGREEMENT. The failure of either party to this agreement to insist upon the performance of any of the terms and conditions of this agreement, or the waiver of any breach of any of the term and conditions of this agreement, shall not be construed as thereafter waiving any such terms and conditions, but the same shall continue and remain in full force and effect as if no such forbearance or waiver had occurred. This agreement constitutes the entire agreement between the parties and any prior understanding or representation of any kind preceding the date of this agreement shall not be binding upon either party except to the extent incorporated in this agreement. Modifications of this agreement shall be binding only if evidenced in writing signed by Applicant and Agency. By submitting this application we the guardians/parents request the agency refer a childcare worker for our employment of same.
IMPORTANT: Children should be between the ages of 3-12. Please provide all requested supplies. In consideration for my child being permitted to participate in the activities and related events and activities, the undersigned acknowledges and agrees that as the natural parent and/or legally authorized guardian, do hereby for myself, my spouse, my child, and on behalf of my/our heirs, personal representatives, and assigned, agree not to sue and hereby release, waive, discharge, hold harmless and indemnify and forever defend Guardian Angels, its Members, individually and collectively, their officers, employees, agents, and directors, from any and all liability, losses, claims, actions, suits, procedures, demands, rights, and causes of action of whatever nature, in law and equity, for any and all known or unknown, foreseen or unforeseen, bodily or personal injuries, death or permanent injury, illnesses, damage to property, or other losses, and any consequence thereof, including expenses, costs, and attorney’s fees, as may be sustained by my child or me arising out of or in any way associated with my child’s participation in camps and related activities, whether by negligence or not to the fullest extent permitted by law. I understand and fully acknowledge that my child’s participation in these activities is solely at our own risk and I assume full responsibility. In signing this registration form, I certify that my child is in good physical condition and has had a physical examination within the past one (1) year and is fully able to participate in all camp activities. Please note any physical condition or medication information that my limit your child’s participation (allergies, asthma, etc.), if any.
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