Loading...

Windsong Ranch Community Association
Caregiver Addendum 

 

  • An Access Card will be issued to a household employee. Limit of two caregiver cards per household may be active at any time.
  • Holder of a Caregiver Access Card may not access Windsong Ranch amenities without the resident they are caring for. 
  • As property owner, I assume responsibility for the household employee’s actions while they utilize Windsong Ranch facilities.
  • I understand that the Windsong Ranch Community Association will regularly audit caregiver cards and that I will have to renew the card. Either through inaction or by not renewing my caregiver card, Windsong Ranch may deactivate the caregiver card asociated with my address.
  • If it is found that this policy is being abused, the caregiver's card is subject to deactivation and must be surrendered. 


ACKNOWLEDGMENT AND AGREEMENT

I certify that the individual listed below is an employee of my household and agree that all obligations under this agreement bind myself, my household employee, and all users of the Facilities. I and my household employee
hereby acknowledge that my household employee is only permitted to access to the Facilities when actively engaged in providing services to my household, including, without limitation, babysitting my child(ren) in my absence, and any violation of this limited use can result in deactivation and surrender of the household employee’s access card.

I have read the rules applicable to the Facilities as found in the Windsong Ranch Governing Documents, and agree that all residents within the household will abide by those rules and all other rules and policies of the Windsong Ranch Community Association.  I acknowledge that the rules applicable to the Facilities and other rules and policies of the Association and Windsong Ranch may be changed from time to time.  The current rules and all governing documents for Windsong Ranch are available at the Association’s Office.

First Owner's Name

First Name*

Last Name*
First Owner's Age Acknowledgment*
First Owner's Date of Birth*
I certify that I am 18 years of age or older
First Owner's Information

What is your (the homeowner's) access card number? It is the five-digit code after the "plus" (+) on the back of your card. *

What is your (the homeowner's) home address? *
First Owner's Signature*
Second Owner's Name

First Name*

Last Name*
Second Owner's Date of Birth*
Second Owner's Information

What is your (the homeowner's) access card number? It is the five-digit code after the "plus" (+) on the back of your card. *

What is your (the homeowner's) home address? *
Third Owner's Name

First Name*

Last Name*
Third Owner's Date of Birth*
Third Owner's Information

What is your (the homeowner's) access card number? It is the five-digit code after the "plus" (+) on the back of your card. *

What is your (the homeowner's) home address? *
Fourth Owner's Name

First Name*

Last Name*
Fourth Owner's Date of Birth*
Fourth Owner's Information

What is your (the homeowner's) access card number? It is the five-digit code after the "plus" (+) on the back of your card. *

What is your (the homeowner's) home address? *
Fifth Owner's Name

First Name*

Last Name*
Fifth Owner's Date of Birth*
Fifth Owner's Information

What is your (the homeowner's) access card number? It is the five-digit code after the "plus" (+) on the back of your card. *

What is your (the homeowner's) home address? *
Sixth Owner's Name

First Name*

Last Name*
Sixth Owner's Date of Birth*
Sixth Owner's Information

What is your (the homeowner's) access card number? It is the five-digit code after the "plus" (+) on the back of your card. *

What is your (the homeowner's) home address? *
Seventh Owner's Name

First Name*

Last Name*
Seventh Owner's Date of Birth*
Seventh Owner's Information

What is your (the homeowner's) access card number? It is the five-digit code after the "plus" (+) on the back of your card. *

What is your (the homeowner's) home address? *
Eighth Owner's Name

First Name*

Last Name*
Eighth Owner's Date of Birth*
Eighth Owner's Information

What is your (the homeowner's) access card number? It is the five-digit code after the "plus" (+) on the back of your card. *

What is your (the homeowner's) home address? *
Ninth Owner's Name

First Name*

Last Name*
Ninth Owner's Date of Birth*
Ninth Owner's Information

What is your (the homeowner's) access card number? It is the five-digit code after the "plus" (+) on the back of your card. *

What is your (the homeowner's) home address? *
Tenth Owner's Name

First Name*

Last Name*
Tenth Owner's Date of Birth*
Tenth Owner's Information

What is your (the homeowner's) access card number? It is the five-digit code after the "plus" (+) on the back of your card. *

What is your (the homeowner's) home address? *
Parent or Guardian's Email Address

Email*

Confirm Email*
Caregiver

Caregiver's Full Name *
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information

What is your (the homeowner's) access card number? It is the five-digit code after the "plus" (+) on the back of your card. *

What is your (the homeowner's) home address? *
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!