IMPORTANT - PLEASE READ BEFORE SIGNING Sample Clauses

IMPORTANT - PLEASE READ BEFORE SIGNING. WE CERTIFY that the information in this Agreement is true and correct to the best of our knowledge, and that we will comply with the rights and responsibilities outlined in this Agreement. WE understand that this information is being given in connection with the receipt of Federal funds and that deliberate misrepresentation may subject either party to prosecution under applicable State and Federal criminal statutes. The Provider certifies he/she has received each of the three (3) previous pages which comprise this document. The Provider certifies he/she is not currently participating in the CACFP with any other Sponsoring Organization. The Provider understands he/she agrees to be sponsored for CACFP participation by the Sponsoring Organization whose name appears on page 1 of this document. (Signature: Representative of Sponsoring Organization) (Date) ______________ ______________ (Signature: Day Care Home Provider) (D.O.B.) (Date) 2 copies with original signatures: 1 to the provider and 1 to the sponsor.
Sample 1
AutoNDA by SimpleDocs
IMPORTANT - PLEASE READ BEFORE SIGNING. I understand the eligibility requirements for the type of HSA contribution I am making, and I state that I do qualify to make the contribution. I have received a copy of the Health Savings Account Application, the 5305-C Custodial Account Agreement, and the Disclosure Statement. I understand that the terms and conditions that apply to this HSA are contained in this Application and the HSA Custodial Account Agreement. I agree to be bound by those terms and conditions. I assume complete responsibility for • determining that I am eligible for an HSA each year I make a contribution, • ensuring that all contributions I make are within the limits set forth by the tax laws, and • the tax consequences of any contributions (including rollover contributions) and distributions. X Signature of HSA Owner Date (mm/dd/yyyy) X Signature of Witness Date (mm/dd/yyyy) X Signature of Custodian Date (mm/dd/yyyy)
Sample 1

Related to IMPORTANT - PLEASE READ BEFORE SIGNING

  • CAREFULLY BEFORE SIGNING Realizing that there are risks inherent in any CHS Summer Camp, and in consideration of my or our child/xxxx'x being allowed to participate in CHS's Summer Camps. I/we agree to assume all risks (whether known or unknown) of participation in Creekside’s Summer Camps, to release and hold harmless Creekside High School and the St. Xxxxx County School District, together with its faculty, staff, employees, coaches, volunteers, trustees and other agents (collectively, the Releasees), from any and all claims, liabilities and damages relating to any injury, sickness, death or destruction of any property which may arise out of, result from or be in any way connected with the participation of my child/xxxx in CHS's Summer Camps, other than claims, liabilities or damages based on the gross negligence of EC or its employees. In addition, I/we agree to indemnify and hold the Releasees harmless from any and all claims for injuries or property damage brought on behalf of myself or our child/xxxx or alleged to have been caused by me or by our child/xxxx while our child/xxxx is participating in CHS’s Summer Camps. I/WE HAVE READ THIS PARTICIPATION, ASSUMPTION OF RISK, WAIVER AND RELEASE OF LIABILITY, AND INDEMNIFICATION AGREEMENT; FULLY UNDERSTAND ITS TERMS; UNDERSTAND THAT I/WE HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT; AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT (OTHER THAN THE OPPORTUNITY TO PARTICIPATE IN Creekside’s Summer Camps, ASSURANCE OR GUARANTEE BEING MADE TO ME/US. I/WE INTEND MY/OUR SIGNATURE(S) TO EFFECT A COMPLETE AND UNCONDITIONAL RELEASE AND WAIVER OF ALL LIABILITY, INCLUDING ANY NEGLIGENCE OF THE RELEASEES IDENTIFIED IN THIS AGREEMENT, AND TO INDEMNIFY THE RELEASEES, TO THE GREATEST EXTENT ALLOWED BY LAW. Parent/guardian name (please print) Parent/guardian signature Date Sworn and ascribed before me on this Day of in the Year

  • PLEASE READ CAREFULLY I, as applicant or duly authorized representative of the applicant, hereby affirm that the submitted information is true and correct to the best of my knowledge. As such, I have been authorized by the applicant to apply for this permit and have read, understand and agree to comply with all rules concerning the use of the Noblesville Parks and Recreation Auditorium at the Ivy Tech Community College Xxxxxxxx County Campus. The applicant agrees that while renting the park or park premise, the applicant will not exclude anyone from participation in, deny anyone benefits of, or otherwise subject anyone to discrimination because of that person’s race, color, sex, religion, creed, national origin or ancestry, age or handicap. Under this Auditorium Rental Agreement, the applicant assumes all responsibility for proper conduct in the park, including consumption of alcoholic beverages. I , on behalf of the permit applicant, shall agree to release, hold harmless, and forever indemnify the City of Noblesville and Ivy Tech Community College, its employees, officers, and agents from any and all claims or causes of action that may arise from the activities described herein. This includes claims for personal injury, property damage, and/or any other types of claim which may arise from these activities, whether such claims may be brought by the permit applicant or any of its agents, or by any third party. I have read this release and understand all of its terms. I agree with its terms and sign it voluntarily. Signature Date City of Noblesville Parks and Recreation Department 000 Xxxxxx Xxxx Noblesville, Indiana 46060 000-000-0000 000 Xxxxxx Xxxx Xxxxxxxxxxx, XX 00000 OFFICIAL EVENT PERMIT APPLICATION FOR AUDITORIUM City of Noblesville Parks and Recreation Department (NPRD) (Please Print or Type) - Auditorium operating hours are 8:00 a.m. - 10:00 p.m. - Permit applications must be submitted to the Department at least six weeks prior to event. - An application for Special Use shall not become a permit until it has been approved and signed by the Department. Application approval will not be finalized without submittal of an application, certificate of insurance and payment of all fees/charges/deposits. Type of Organization: (check all that apply) □City of Noblesville □Department-Affiliated □Private – City Resident □Xxxxxxxx County □Non-Profit □Private – Non-Resident □Other Tax ID# □Profit Making Please complete entire application: Non-Profit Fundraising Event □Other Tax ID# Date of Application: Date of Proposed Event: Contact Information:

  • PLEASE READ THIS NEXT SECTION CAREFULLY Although there will be circumstances when it is appropriate to seek parental consent, children’s data protection and privacy rights are their own. The law considers that children of average maturity will, from the age of around 12, have sufficient awareness of their own privacy to make certain choices relating to their personal data themselves. Parents’ views remain important, but sometimes the law will require us to give more weight to the decision the child makes about his or her own privacy. For most purposes, it will not in fact be necessary or practical for us to obtain consent from you (or your child) for the use we make of your (or your child’s) personal data. The law recognises this but also requires that, as far as possible, we set out clearly what these uses will be. Please also see our 'Privacy Notice' which is available on the School's website.

  • IMPORTANT NOTICE 为了保护甲方的自身权益，银行特此向甲方作出如下提示和建议： In order to protect Party A’s rights and interests, the Bank kindly reminds that:

  • OTHER IMPORTANT TERMS 11.1 We may transfer our rights and obligations under this XXXX to another organisation, but this will not affect your rights or our obligations under this XXXX.

  • Important Information The Employee agrees to indemnify and hold the Employer and National Benefit Services, LLC (NBS) harmless against any and all actions, claims, and demands that may arise from the purchase of annuities or custodial accounts in this 403(b)

  • Important Information About Procedures for Opening a New Account To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial organizations to obtain, verify, and record information that identifies each person who opens an account. What this means for you: When you open an account, you are required to provide your name, residential address, date of birth, and identification number. We may require other information that will allow us to identify you.

  • COMPLIANCE WITH EQUAL OPPORTUNITY ORDINANCE Contractor shall comply with the City’s Equal Employment Opportunity Ordinance as set out in Section 15-17 of the Code of Ordinance.

  • What Will Happen After We Receive Your Letter When we receive your letter, we must do two things:

  • Certification of Meeting or Exceeding Tobacco-Free Workplace Policy Minimum Standards A. Grantee certifies that it has adopted and enforces a Tobacco-Free Workplace Policy that meets or exceeds all of the following minimum standards of:

Time is Money Join Law Insider Premium to draft better contracts faster.