Participant Signature. Date: __________
Participant Signature. Date Returned: WIC Staff Signature: Legend: For Official WIC use ONLY (Manual Form Instructions: Please CIRCLE one option below)
Participant Signature. Date: __________ Case Manager Signature: __________________________________________ Date: __________ Housing Search Case Plan Participant Name: Date:
Examples of Participant Signature in a sentence
Participant Name (print) Date of Birth Participant Signature Date I, the parent/legal guardian of the Participant, hereby agree to the above on behalf of the Participant.
Printed Name of Participant Signature of Participant Date Date of Birth Emergency Contact Name Emergency Contact Number PARENTAL / LEGAL GUARDIAN CONSENT I attest that I am the parent or legal guardian of the minor participant named above.
Participant Signature Date IMAGE/VOICE PERMISSION Photographic images or video/audio recordings may be taken of you and/or your child during program activities.
Printed Name of Participant Signature of Participant Date PARENTAL/LEGAL GUARDIAN CONSENT I attest that I am the parent or legal guardian of the minor participant named above.
Participant Name (print) Date of Birth Participant Signature Date (If the participant is a minor) I, the parent/legal guardian of the Participant, hereby agree to the above on behalf of the Participant.
More Definitions of Participant Signature
Participant Signature. Date: Participant email: Next appointment (or best time to call) Health Coach Signature: Date: *Items with an asterisk are required
Participant Signature. Date: Case Manager Signature: Date:
Participant Signature. Date: New Member Orientation: I provided an orientation to the above named Participant regarding the proper use and care of the Wellness Center and equipment. The Participant has received the Wellness Center Policies and Rules and agrees to abide by them. This Participant has also reviewed and signed the Wellness Center Agreement and Release of Liability form.
Participant Signature. Dated: / / Participant Printed Name: Participant Address: Participant Date of Birth: / / IF PARTICIPANT IS UNDER 18 YEARS OF AGE, THIS AGREEMENT MUST ALSO BE SIGNED BY PARTICIPANT’S PARENT OR LEGAL GUARDIAN. By my signature below, I attest that I am the parent or legal guardian of the above-named participant, that the information expressed in this document is true and accurate, and that I agree to abide by all terms and conditions herein both for myself and on behalf of the Participant named above. Parent or Guardian Signature: Date: / /
Participant Signature. Print Name: FIRST FOUNDATION INC. By: Name: Its: 1 Applicable only to Participants who are employees of the Company or of any Company Affiliate.
Participant Signature. Date: MBA Executive Director Signature: Date: Participant & Model Home Information: All further Parade information will be sent to the contact person as designated below. It is the responsibility of this person to distribute necessary information to the appropriate parties. Company Name: Contact Name: Address: City, State, Zip: Phone: Fax: Email: Model Name: Home Style: Parade Subdivision: Lot #: Acknowledgement of Contract / Rules & Regulations Your signature acknowledges that you have read this Contract and the Parade’s Rules & Regulations, and accept the terms. Print Name Title Signature Date Performance Deposit & Fees (due with contract): Please note that to receive early bird pricing contracts must be received by the date indicated below. If payment is not received with contract, the MBA will invoice your company for the total. The Performance Deposit is eligible to be refunded based on Participant adhering to the deadlines established in the Rules & Regulations section of the contract. The Participation Fee is non‐refundable. ■ Performance Deposit: $5,000 ■ Participation Fee: $4,000 due no later than December 12, 2018November 1, 2019 (Early Bird) / $5,500 after December 12, 2018November 1, 2019 (General Pricing) Payment Parade of Homes payments must be made by check. Credit card payments are not allowed. Enclose a check payable to the ‘Metropolitan Builders Association’ for the following amount and mail to ‘Metropolitan Builders Association, Attn: Xxxxx Xxxx, N16 X00000 Xxxxx Xxxxx Xxxxx, Xxxxxxxx, XX 00000’: Early Bird Pricing: $9,000 received by the MBA no later than November 1st, 2019. General Pricing: $10,500 received by the MBA after November 1st, 2019. Do Not Complete this Section. For MBA Use Only. Amount: Received: Date: Check #: Accepted by the MBA once paid in full. Rules & Regulations APPLICABILITY These Rules & Regulations are part of your signed Participation Contract. By signing the Parade of Homes Participation Contract, you are agreeing to abide by all Rules & Regulations specified in this document. Monetary fines will be applied and possible expulsion from the Parade if your company, employees or representatives are in violation of these Rules & Regulations at any time during the event. MBA shall have full power to interpret and to make or amend these rules from time to time, within its sole discretion. Wherever these Rules & Regulations do not cover a situation, MBA’s Executive Director shall have the right to make such rulings ...
Participant Signature. Last Name: PLEASE PRINT First Name: PLEASE PRINT Street: City: Prov/State: Postal/Zip Code: Age: Sex: Email Address: Phone Number: ( ) - Witness Signature For Participants under the age of 18 Parent/Guardian Signature: Witness Name: PLEASE PRINT Parent/Guardian Signature: PLEASE PRINT THIS RELEASE AGREEMENT MUST BE COMPLETED IN FULL, DATED, SIGNED AND WITNESSED PRIOR TO PARTICIPATING IN ANY ADVENTURE ACTIVITIES AT SNOW VALLEY AERIAL PARK. Here's what happens: Participants will be fitted into a harness by a guide and will then attend an orientation demonstration on use and safety. Participants must demonstrate the ability to use the equipment and manage risks properly before being allowed to proceed on the aerial adventure course. They must remain attached to a cable at all times and follow the rules of the course. In cases where an adult is required to supervise a child/youth, the supervising adult must watch or participate in the demonstration and ensure that the child/youth remains attached to a cable at all times and follows the rules of the course. I understand and agree to the requirements for this activity: INITIAL: Privacy Policy: Snow Valley Aerial Park and our affiliated entities collect and use personal information (first and last name, physical address, age and weight) to meet legal and insurance requirements for operating our park activities, Guests providing us with their email addresses allow us to confine their reservations and create unique guest profiles in our guest database. This allows us to be able to serve our guests more quickly and efficiently when they make future reservations or check-in at our parks. If guests provide us with additional permission, their email address is included in a database of guests seeking periodic communication from Snow Valley. Guests can choose to have their email address removed from this database at any time. Snow Valley may use personal information in aggregate provided by our guests (city and age) for marketing and business development purposes: Snow Valley Aerial Park does not sell your information or provide your information to others outside of our organization and its affiliate companies. ☐ Yes, please send me special offers and Snow Valley news by email! In addition to agreeing to SNOW VALLEY AERIAL PARK'S RELEASE, I understand and agree: To be bound by all of Snow Valley's registration conditions; To familiarize myself with Snow Valley's activity safety guidelines; To inform Snow Valley of...