The undersigned has/have applied through the Chance for Hope Foundation for guest accommodations to be furnished to the undersigned and his, her, or their minor children at the SYNC Med Center (the “Property”) located at 2950 Old Spanish Trail in Houston, Texas during the hospitalization, treatment, diagnostic testing for the patient named above.

 

The undersigned has/have been provided information on the Property and short-term housing program and the Chance for Hope Foundation has agreed to furnish such guest accommodations. 

 

In order to furnish guest accommodations to the undersigned and on behalf of any minor children of the undersigned who will share the accommodations, the undersigned hereby voluntarily assume(s) all risks of accident, injury to persons or damage to personal property arising out of or in connection with the occupancy of said accommodations or the furnishings thereof, including without limitation, any injury or damage occurring for any reason in or upon the real estate owned, leased or occupied by the Chance for Hope Foundation at the aforesaid address.

 

The undersigned for himself, herself or themselves, and on behalf of said minors, hereby remise(s) and release(s) and forever discharge(s) the Chance for Hope Foundation, and its Directors, Officers, Staff and/or Volunteers (the “Releasees”) from any and all demands, actions, causes of actions, suits, claims, damages, and/or liabilities whatsoever arising out of or in connection with any event, occurrence or incident arising from or in any way related to the occupancy of accommodations at the Property, whether caused by the negligence of any of the parties so released or otherwise.

 

The undersigned hereby further agree(s) to indemnify, hold harmless and defend any and all of the said Releasees against any and all such claims or liabilities asserted against them or any of them by third persons by reasons of any acts or omissions of the undersigned or his, her or their minor children or animals, or any other circumstances occurring during the period that said accommodations are being furnished.

 

Due to the generosity of our supporters, the Chance for Hope Foundation is pleased to offer temporary housing free of charge to pediatric cancer patients and their families on an as-available basis. The Chance for Hope Foundation is dedicated to helping as many people as possible. We thank you for your adherence to the following policies, which are designed to help us use our budget wisely. In exchange for temporary housing, we require Housing Program participants honor these policies.

 

Participants who do not honor these policies may be asked to vacate the premises.

 

All participants in the Chance for Hope Foundation Housing Program must honor the following policies:

 

Length of Stay: The Chance for Hope Residence is provided free of charge to pediatric cancer patients and their families on a first-come, first-served basis, and on a temporary basis only (no more than 8 weeks per visit). All tenants must be able to provide proof that they have a permanent home to which they will return after their temporary stay. Tenants who abuse the 8-week maximum stay, will be charged $100/per day for every day they stay beyond their agreed checkout date. The Chance for Hope Foundation recognizes that treatment for cancer can be unpredictable and you might need to remain in the area for treatment. Every effort will be made by the Chance for Hope Foundation to accommodate such circumstances when absolutely necessary. However, no guarantees can be provided since we are attempting to help as many people as possible and may have made a commitment to other patients on our schedule.

 

Security Deposit: Participants are required to follow all facility policies. All program participants must provide a credit card deposit in the amount of $500 in advance of their stay. This deposit will be refunded upon check out, provided that the apartment is in good condition and repair. Any and all damage to the apartment or its contents will be the sole responsibility of the program participant.

 

No Smoking or Pets: It is important to provide a clean, allergen-free environment for patients. The apartments are subject to a strict no smoking and no pets (of any kind) policy.

 

Check-Out Procedures: All participants must notify the Chance for Hope Foundation in advance of departure. Please provide as much notice as possible so that we may accomodate future check-in for other families. Upon check-out, all keys and parking stickers must be returned to the Chance for Hope Foundation. There will be a $200 charge to your credit card if all keys and parking stickers are not returned.

 

Minors: All children under the age of 18 must be supervised by an adult at all times. Children are not allowed to use any of the facilities including the apartment without the supervision of an adult.

 

Utility Charges: Normal utility usage is expected. Every effort should be made not to waste electricity. Please turn off lights when you leave each room and leave doors and windows closed to keep the apartment cool in the summer and warm in the winter. Electricity usage charges over $100/month will be charged to your credit card.

 

I agree that my family and I will abide by these policies:

This information is for our records only. You will be sent an invoice for the payment of your deposit upon move-in.

ALL information requested in this application is needed for the processing of your housing application by the Chance for Hope Foundation.