Liability Agreement. In order for Monadnock at Home to monitor my/our needs and levels of satisfaction, I/we authorize third-party providers to share non-medical data with MaH about the services I/we use. MaH reserves the right to be in touch with my/our emergency contacts in case of situations of (serious) health or safety concern. As a member of Monadnock at Home, I/we hereby release and discharge Monadnock at Home from personal responsibility or liability for services rendered by Monadnock at Xxxx xxxxx, volunteers or third parties acting on its behalf. I/we have read the above carefully and hereby request membership in Monadnock at Home under the terms and conditions described.
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Samples: monadnockathome.org, www.monadnockathome.org, www.monadnockathome.org