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Homeowner Wellness Policy Receipt Acknowledgement

 

 

I have received a copy of Rebuilding Together Fox Valley’s (RTFV) Homeowner Wellness policy.  I have read and understood the policy.  If I have any questions about the policies stated I will ask a Rebuilding Together Fox Valley Staff member to answer them.  I shall follow all of the policies stated. In addition, I realize that Rebuilding Together Fox Valley may change the policies stated at any time.

 

I understand and acknowledge that even when following RTFV Wellness policies there is still a risk for contracting CoVID-19 or transmitting COVID-19 to others. I understand that failure to comply with the RTFV Wellness Policies will result in my stoppage of work at my home. RTFV staff members will be monitoring for compliance of safety policies and will have ultimate authority in all safety matters. I hold harmless Rebuilding Together Fox Valley, its affiliates, officers, directors, employees, volunteers or agents (collectively “Rebuilding Together Fox Valley Affiliates”) from any cause of action, claim, loss, demand, or suit arising from or related to: (1) the presence of any Rebuilding Together Fox Valley Affiliate or Contractor(s) on or about the Premises, (2) any services provided by any Rebuilding Together Fox Valley Affiliate, Volunteers, or Contractor(s); (3) the negligence of any Rebuilding Together Fox Valley Affiliate, Volunteers, or Contractor(s); (4) any damages to personal or real property; or (5) any injuries sustained by myself, any of my family members, or any of my invitees. 

 

 

                                                                        Homeowner:____________________________

 

 

                                                                        Date: ___________________________________        

Rebuilding Together Fox Valley
1800 Appleton Road
Menasha, WI 54952
info@rtfv.org
(920) 730-2156
www.rtfv.org
Office Hours:
Monday - Thursday: 8:00am - 4:00pm
Friday: 8:00am - 12:00pm
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