Dorm Check-in & Check-out Form
Full Name
*
First Name
Last Name
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@example.com
Booking Type:
*
SESSIONAL INSTRUCTOR
STAFF
STAFF (FULL-TIME)
VISITOR
VOLUNTEER
Room Preference: Dorms are gender-specific due to shared amenities.
*
Female Bunk
Male Bunk
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
Payment Type:
*
EMT: The Housing Manager can provide the email address and password.
INTERAC/CASH: In-person at the Finance Dept. (located in the Trades Building)
CREDIT CARD: Over the phone or in-person at the Finance Dept.
CHARGE ACCOUNT: Please proceed to the next question.
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. 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
Submit
Should be Empty: