UnBQ Dorm Reservation
STUDENTS
Full Name
*
First Name
Legal Last Name (please add any other last name, if applicable)
Address
*
PO Box #
Street Address
City
Province / State
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@unbq.ca
If you have a vehicle on site, please provide make/model/colour and license plate #:
Have you already paid a damage deposit?
*
YES
NO - You may be required to pay a damage deposit fee.
Check-in Date:
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Check-out Date:
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Dorm Type: Dorms are designated by gender because of the shared washroom and shower amenities.
*
Female Bunk
Male Bunk
Do you require any special accommodations?:
Booking Type: (rates are determined by Program enrollment)
*
Please Select
CEMT Program
mâcîhtâtân Entrance Program
Leadership & Management
Diploma of Social Work
Indigenous Bachelor of Social Work
Early Learning Educator
BA of Arts - nehi/DENE
ITEP
nêhiyaw okiskinohamâkêw Certificate
Masters/Doctoral/Governance Program
Monthly Rent: (Full-time)
** If you selected "MONTHLY RENT" the Housing Manager will be in touch with you.
Payment Type:
*
INTERAC/CASH: In-person at the Finance Dept. (located in the Trades Building)
EMT: The Housing Manager can provide the email address and password.
CREDIT CARD: Over the phone or in-person at the Finance Dept.
SPONSORSHIP: MUST provide a confirmation letter from your sponsor.
OTHER: Ex: pre-paid from a previous reservation not used.
*Is this booking replacing a previously paid reservation? If so, provide some details:
DISCLAIMER: 1. I must give 24-hour notice if cancelling my room reservation otherwise I will be charged for one-night stay. 2. I understand that if leave my personal belongings in the dorm, I will be responsible for the nightly dorm fee, as it will be deemed unrentable. 3. If there are any damages to the room or property, I consent to forfeiting some or all of my damage deposit to cover all expenses related to repairs or the replacement of items provided by UnBQ.
*
Yes
Do you have any medical conditions or history that we should be aware of?:
Emergency Contact:
*
First Name
Last Name
Emergency Contact Phone #:
*
Please enter a valid phone number.
Format: (000) 000-0000.
DORM RENTAL LIABILITY WAIVER: 1. Assumption of Risk - I, the undersigned, understand that staying in a short-term, high-density, or campus-style dorm environment involves inherent risks, including but not limited to: property damage, loss of personal property, slip and fall injuries, fire, and contact with other guests. I voluntarily assume all risks, both known and unknown, associated with my stay. 2. Waiver and Release of Liability - I, for myself and on behalf of my heirs, assigns, and representatives, hereby release, waive, and discharge Universitynuxełhot’įne thaaɁehots’į nistameyimâkanak Blue Quills, its employees, and agents from any and all liability, claims, or causes of action for property damage, personal injury, or wrongful death occurring to me or my guests arising out of or related to this agreement. ACKNOWLEDGEMENT: I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTOOD THIS RELEASE AGREEMENT before consenting to it, that I have executed this Release Agreement voluntarily, and that this Release Agreement is to be binding upon myself, my heirs, executors, administrators and representatives
*
Yes
Signature
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