Key Holder Agreement Form

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

I, the undersigned, acknowledge that I have been provided with keys and security codes for the purposes of conducting business for the Muscle and Joint Clinic Mississauga. By signing this agreement, I agree to the following terms:

Key Usage:
- I understand that these keys are strictly for business purposes and I agree not to share, loan, or duplicate any of the keys issued to me.

Security Code Confidentiality:
I will not share my security code(s) with any unauthorized persons.

Lost or Misplaced Keys:
In the event that I lose any key during my employment, I agree to be responsible for the replacement costs of the keys and locks (current value = $250)

Key Return:
I agree to return all keys issued to me by the Muscle and Joint Clinic Mississauga by my last day of employment. Should I fail to return any key, I understand and agree that the cost of replacing the key and/or lock will be deducted from any final payment owed to me by the Clinic.

Key Number (#) Being Issued*

Signature*