A Bed for Izzy, Inc. Application

Applications are reviewed on a rolling basis. Our team assesses each submission and selected recipients will be notified via email or phone. Thank you for contacting us!

Policy and Procedures

How to Apply: 

• Completed Jotform application
• Must include: Doctor’s order and Occupational Therapy evaluation
• Optional: include a description or link to the type of bed that is needed.

Eligibility Requirements:

• A Bed for Izzy, Inc. understands the immense obstacles that are faced when trying to obtain a safety bed for someone in need. For that reason, there is no established income restrictions or diagnostic criteria. However, we do ask that you submit a letter from the applicant's doctor that states the doctor’s recommendation and need for a safety bed and an OT evaluation. This is to have a documented assessment of need. If not included with this application, these documents are due within 90 days of your application. Without these documents within 90 days of application, we will have to archive your application until the required documents are received. If you are having difficulty obtaining either of these required documents, please contact us at abedforizzy@gmail.com.
• Applicants are limited to Missouri residents. 

Agreement for Support: 

• A Bed for Izzy, Inc. reserves the right to select the recipient for support from the list of applicants based on prioritization of need and at the discretion of the Board of Directors. Applications will be reviewed on at least a quarterly basis or as additional funding opportunities are available. 
• A Bed for Izzy, Inc. in collaboration with the individual, guardian, and team members will determine the appropriate bed for the individual and together obtain a cost quote for the bed. Payments will be made directly to the company for purchase of the bed. 
• A Bed for Izzy, Inc. relies on the community of the individual being supported to raise funds. It is expected that the individual’s family actively participate in the fundraising process via assisting with fundraising events, engaging in social media content, and supporting the fundraising efforts to the best of their ability.
• While a media release is not required for eligibility purposes, the use of pictures, videos, stories, and names is significantly helpful in the fundraising efforts as it allows A Bed for Izzy, Inc. to share the individual’s story and provide a face to the funding. Please be aware that this is the model we use for fundraising, and if the guardian chooses to not consent to the use of media, it will likely delay the fundraising process.
• All information obtained on this application will be kept confidential until media release is signed and fundraising campaign begins. 
• If a recipient no longer needs the safety bed, it is required that the family will contact A Bed for Izzy, Inc. to inquire about donating the bed to another individual in need. The recipient agrees that the bed is not allowed for resale under any circumstances unless direct written agreement is received from A Bed for Izzy, Inc. and its board of directors.

Release of Liability

This Release of Liability and Hold Harmless Agreement is made and entered into by the undersigned recipient or the Recipient’s legal guardian, in favor of A Bed for Izzy, Inc., its officers, directors, employees, volunteers, and affiliates (collectively, "A Bed for Izzy").

1. Acknowledgment of Risk
The Recipient acknowledges and understands that the bed and/or any related sleep products ("Equipment") provided by A Bed for Izzy are received as a donation. The Recipient acknowledges that:

The Equipment is new and may be covered by a manufacturer’s warranty. Any warranty claims should be directed to the manufacturer.
The Recipient assumes all risks associated with the use of the Equipment, including but not limited to, injury, illness, or damage to property.
It is the responsibility of the Recipient to ensure proper assembly, maintenance, and appropriate usage of the Equipment.
2. Release and Waiver of Liability
The Recipient, on behalf of themselves, their child (if applicable), heirs, assigns, and legal representatives, hereby voluntarily waives, releases, and discharges A Bed for Izzy from any and all claims, liabilities, demands, actions, or causes of action, known or unknown, arising out of or related to:

The condition, use, or misuse of the Equipment;
Any injuries, damages, or losses that may occur due to the Equipment’s use;
The actions, omissions, or negligence of A Bed for Izzy in providing or distributing the Equipment;
Any harm or neglect resulting from the use or misuse of the Equipment.
3. Indemnification
The Recipient agrees to indemnify and hold harmless A Bed for Izzy from any and all claims, damages, losses, liabilities, or expenses (including attorney’s fees) arising from the use of the Equipment.

4. No Medical or Professional Advice
The Recipient acknowledges that A Bed for Izzy is not a medical provider, and the provision of the Equipment is not a substitute for medical, professional, or safety advice. The Recipient is encouraged to consult a qualified professional regarding the suitability of the Equipment for their specific needs.

5. Severability
If any provision of this Agreement is found to be invalid or unenforceable, the remaining provisions shall continue in full force and effect.

6. Acknowledgment and Signature
By signing below, the Recipient acknowledges that they have carefully read this Agreement, fully understand its contents, and voluntarily agree to its terms. The Recipient further affirms that they are at least 18 years of age or have the legal authority to sign on behalf of a minor child.

 

Media Release - Authorization

 As the legal guardian of this applicant, I consent to the use of pictures, videos, and other forms of media to be taken and published on social media platforms and A Bed for Izzy website for the purposes of promotion, advertising, and highlighting A Bed for Izzy services. I understand that if at any time I chose to revoke my consent, written and signed notice must be provided to A Bed for Izzy, Inc. To revoke my consent, written notice must be provided to abedforizzy@gmail.com.

 

By signing the space below, you are certifying that all information is correct and that you are the person completing this application. In Missouri, electronic signatures are legally binding and have the same legal effect as handwritten signatures. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.