Fall 2022 Student Housing Agreement "*" indicates required fields Step 1 of 10 10% McDougle Technical Institute (MTI) grants a license to the Student to reside in the assigned space for the semester. The relationship created by this license between MTI and the Student is that of licensor and licensee, and NOT that of landlord and tenant. The Student must be officially admitted and enrolled for credit-bearing coursework at MTI and be making satisfactory academic progress to live in the residence halls. MTI reserves the right to provide priority assignments to students who are classified as full-time and are in good standing in academic degree programs and whose conduct at MTI has not been determined by MTI to be incompatible with community living. The Student must officially check out of the residence hall if he/she is not enrolled in classes, withdraws or is withdrawn from MTI. Failure to do so will result in removal from the residence hall. MTI does not discriminate based on sex, race, color, sexual orientation, national origin, citizenship, religion, veteran status, age, or disability.McDougle Technical Institute student housing residents must read and electronically sign the Student Housing License Agreement (Agreement). If the resident is under 18 at the time they electronically sign the Agreement, a parent or Legal Guardian signature is also required. Parent or Legal Guardian signature authorizes the student to enter the Student Housing License Agreement. Parent or Legal Guardian signature also demonstrates understanding that their student is financially liable for all charges and bound by the Agreement. By signing this agreement, the student agrees to be bound financially for the entire semester. This agreement is subject to and subordinate to the liens of any mortgages or deeds of trust now or hereafter encumbering or affecting the property. Do you agree to comply with the terms and conditions of this agreement, all federal and state laws, all MTI policies and regulations governing student conduct including the MTI Student Code of Conduct and Student Housing Handbook?*YesNoHave you read and do you understand the student housing rules?*YesNoMcDougle Technical Institute Student Housing License Agreement* I agree to the McDougle Technical Institute Student Housing License AgreementBackground A. School operates a student residence dormitory in order to provide student housing to enrolled Students during specified times of the academic year. B. Student is a prospective or enrolled Student that either intends to enroll or remain enrolled in the School for the duration of the term of this Agreement. C. Student has previously submitted an application to School expressing a desire to occupy and utilize an assigned space in one of the School’s dormitories, and Student understands that the School shall assign the particular facility and room (the “Space”) subsequent to Student’s execution of this Agreement. D. Student is required to execute this Agreement in order to secure a Space, and School and Student enter into this legally binding Agreement to set forth the terms and conditions of their agreement governing Student’s occupancy and use of the Space. E. For purposes of this Agreement, “Student” includes those students enrolled in a postsecondary institution of higher education with which the School has an affiliation agreement to provide residential student housing services. In consideration of the mutual promises and covenants contained herein, Student agrees to abide by the written mandatory housing guidelines provided and the payment terms. Effective Date This Agreement becomes effective and enforceable immediately upon the Effective Date, which is the date the Student signs this Agreement. However, Student is not assured of an assigned Space unless and until Student has paid to the School the required prepaid rent in accordance with this Agreement, or School has recognized such payment as deferred. Grant of Use In exchange for Student’s payments to School in accordance with this Agreement, and subject to all of its terms, conditions, and restrictions, School grants conditional authorization to Student to occupy and use the Space, to be determined and assigned to Student within the School’s sole discretion. Student must be enrolled in the School or in a postsecondary institution of higher education with which the School has an affiliation agreement to provide residential student housing services in order to be eligible for, or to remain in, School housing. Student’s occupancy of the Space shall officially begin when the Student signs in to his/her assigned Space. Payment Entering into this Agreement legally obligates Student or if Student is under age 18, the Student’s parent or guardian to make payment to the School for the assigned Space, regardless of any Student-indicated preferences concerning a specific room type, location, or roommate. School’s assignment of a Space to Student, and Student’s continued occupancy of a Space, are contingent upon Student’s final admission to the School and timely payment of all charges and fees to School, including those due under this Agreement. The School (or the School’s designee), in its sole and absolute discretion, may cancel this Agreement or change Student’s Space assignment in the interest of order, discipline, health, safety, security, maximum utilization of Schools facilities and resources, and/or educational delivery, or for the Student’s failure to pay rent or charges in a timely manner. The housing fee is non-refundable. If a Student moves out early, the cost will remain the same. No prorations or refunds will be allowed. The only extra cost to this agreement will be if a Student exceeds the allotted time to complete his/her educational program. In this case, McDougle Technical Institute will charge on a month by month basis for the remainder of the Student’s stay. There is a $250.00 non refundable reservation fee. By Signing this Application, Student is reserving a space and agrees to abide by the written mandatory housing guidelines provided to Student and the payment terms.Please make sure you read and understand the student housing rules before you agree to the Student Housing License Agreement. If you do not agree to comply you can not continue. Do you agree to make payments for all student housing fees, and any other additional charges for the applicable period?*YesNoDo you agree to maintain your assigned space in a clean and safe manner at all times?*YesNoDo you agree to move to a different space, room, building or location if required?*YesNoMTI reserves the right to change, cancel, or consolidate room assignments at any time due to academic ineligibility, discipline, safety, health, or administrative reasons.Do you understand and agree that visitors are NOT allowed in private residential areas?*YesNoDo you understand and agree that for the safety of all residential students there is a 11pm curfew that is strictly enforced?*YesNoIf you arrive after 11pm you will receive a housing violation. After 11pm the building is locked down and will not reopen till 6am. Do you understand and agree that MTI staff or other designated agents necessary to the operation of the residence halls may enter a student’s room at any time to verify inventory records, occupancy, perform maintenance, perform security investigations, or enforce safety, health, or MTI Code of Conduct standards.*YesNoDo you understand and agree that MTI Housing reserves the right to terminate this agreement by written notice with due process if a student fails to comply with any terms and conditions of this agreement.*YesNoIf you do not agree to comply you can not continue. COVID- 19 TestingBefore a student can check in, the student is required to provide documentation of a negative COVID-19 test taken within the last 72 hours.Do you understand and agree that you will not be permitted to check into the room assignment if a negative test is not presented by the time of check in.*YesNoDo you understand and agree that you will comply with any and all COVID-19 safety protocols.*YesNoThis could include wearing a mask, social distancing, temperature checks, surveys and frequent COVID-19 testing. Assumption of Risk and Waiver of Liability Relating to Coronavirus/COVID-19* I agree to the Assumption of Risk and Waiver of Liability Relating to Coronavirus/COVID-19The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend physical distancing and have, in many locations, prohibited the congregation of groups and people. McDougle Technical Institute (Organization) has put in place preventative measures to reduce the spread of COVID-19; however, the Organization cannot guarantee that you, or any other person, will not become infected with COVID-19. Further, participating in programs at McDougle Technical Institute could increase your risk of contracting COVID-19. Therefore, if you choose to participate you are required to acknowledge and execute this Waiver. ACKNOWLEDGEMENT By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by participating in programs at McDougle Technical Institute and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at Organization activities may result from the actions, omissions, or negligence of myself and others, including but not limited to McDougle Technical Institute employees, volunteers, vendors, sponsors and program participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury myself, including, but not limited to, personal injury, disability, death, illness, damage, loss, claim, liability, or expense or any kind, that I may experience or incur in connection with my attendance at McDougle Technical Institute activities or programming. On my behalf, I hereby release, covenant not to sue, discharge, and hold harmless and indemnify the McDougle Technical Institute , its officials, employees, agents, sponsors, vendors and representatives, of and from any and all claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any claims based on the actions, omissions, or negligence of the McDougle Technical Institute , its employees, agents and representatives, whether a COVID-19 infection occurs before, during, or after participation in any McDougle Technical Institute program.If you do not agree to comply you can not continue. Personal PropertyStudent personal property is the responsibility of each individual student. Under NO circumstances will McDougle Technical Institute be responsible for your belongings. You can contact NSSI to purchase Personal Property Insurance For College Students. Customer Service 1 800 256 6774 or https://www.nssi.com/opt/mcdougletechnicalDo you acknowledge, understand and agree that McDougle Technical Institute is not liable for loss, theft, or damage of personal property?*YesNo Do you have personal property insurance coverage?*YesNoIf you do not agree to comply you can not continue. Medical Conditions and AllergiesDo you have any medical conditions or allergies that we should be aware of?*NoYesPlease explain* Health Insurance RequirementDo you have medical insurance?*NoYesMcDougle Technical Institute requires you to carry medical insurance in order to help defray eligible medical costs in the event of an injury or sickness. We have selected student injury and sickness insurance provided and administered by UnitedHealthcare StudentResources. The cost is $609 per semester. This cost will be added to your student ledger unless you are currently covered by a comparable plan. You have the option to complete a Waiver Form to request a review of your existing coverage. If we determine that your coverage meets our minimum coverage standards, you will not be required to enroll in the student insurance plan. Under NO circumstances will McDougle Technical Institute be responsible for your medical expenses. You can enroll or waive out of the policy at https://studentcenter.uhcsr.com/mti Family Educational Rights and Privacy Act (FERPA)*Parent/Guardian Email* FERPA Consent*The Family Educational Rights and Privacy Act (FERPA) is a federal law that affords parents the right to access their children’s education records, the right to seek to have the records amended, and the right to have some control over the disclosure of personally identifiable information from the education records. When a student turns 18 years old, or enters a postsecondary institution at any age, the rights under FERPA transfer from the parents to the student. I consent to the release of my records to my parent(s) or guardian(s) listed below for the purpose of keeping them informed about my enrollment at McDougle Technical Institute. I understand that education records include, but are not limited to, information about my academic standing, disciplinary issues and financial obligations to the Institute. I acknowledge that I may submit a subsequent notification in writing directing the Institute to no longer release information to any or all of the individuals listed below. McDougle Technical Institute is authorized to release information to the following individuals. I do not consent to the release of my education records to my parent(s) or guardian(s). Parent/Guardian Name* First Last Parent/Guardian Phone*Is your Parent/Guardian your Emergency Contact?YesNoEmergency Contact Email* Emergency ContactEmergency Contact Name* First Last Relationship to Participant*ParentFamily MemberFriendOtherEmergency Contact Phone* Student ConsentWaiver of Liability and Release* I agree to the Waiver of Liability and ReleaseFor and in consideration of the undersigned participant’s registration with the McDougle Technical Institute (“Organization”) and being allowed to participate in events and member activities, participant and the parent(s) or legal guardian(s) of participant (if Participant is under 18) waive, release and relinquish any and all claims for liability and cause(s) of action, including for personal injury, property damage or wrongful death occurring to participant or participant’s parent(s) or legal guardian(s) arising out of participation in events, or sports, and/or activities incidental thereto, whenever or however they occur and for such period said activities may continue, and by this agreement any such claims, rights, and causes of action that participant and/or participant’s parent(s) or legal guardian(s) may have are hereby waived, released and relinquished, and participant and participant’s parent(s)/guardian(s) do so on behalf of their heirs, executors, administrators and assigns. Participant and participant’s parent(s)/guardian(s) acknowledge, understand and assume all risks relating to events or sports participation and activities incidental thereto, and understand that activities incidental thereto involve risks to participant’s and participant’s parent(‘s)/ guardian(‘s) person including bodily injury, partial or total disability, paralysis and death, and damages which may arise there from and that they have full knowledge of said risks. These risks and dangers may be caused by the negligence of the participant, participant’s parent(s)/ guardian(s)or the negligence of others, including the Organization, its affiliates, members, event hosts, other participants, other parents and legal guardians, coaches, officials, sponsors, advertisers, owners and operators of the premises used to conduct any event and each of them, their officers, directors, agents and employees (collectively, “releasees”), and include risks arising from the conditions and use of facilities and related premises. I/We further acknowledge that there may be risks and dangers not known to us or not reasonably foreseeable at this time. Participant and participant’s parent(s)/guardian(s) acknowledge, understand and assume the risks, if any, arising from the conditions and use of facilities and related premises, whether as a participant or a spectator, including without limitation, the risks involved with participating in the Organization’s activities. Participant and participant’s parent(s)/guardian(s) further acknowledge and understand that included within the scope of this waiver and release is any cause of action (including any cause of action based on negligence) arising from the performance, or failure to perform, maintenance, inspection, supervision or control of said areas and for the failure to warn of dangerous conditions existing at said facilities, for negligent selection of certain releasees, or negligent supervision or instruction by releasees. Participant and participant’s parent(s)/guardian(s) acknowledge and understand that the Organization reserves the right to photograph facilities, activities and program participants for potential future use. All photos remain the property of the Organization and may be used for promotional services. Participant and participant’s parent(s)/guardian(s) grant permission for the Organization to publish, copyright, or use all films, photographs, computer- generated imagery, and printed and spoken words in which participant is included, whether taken by staff, volunteers, participant’s, or others. Participant and participant’s parent(s)/guardian(s) further agree that the Organization can use these photographs, films and words for any exhibitions, displays, web pages and publications, without reservation or compensation. Consent to Medical Treatment: Participant and participant’s parent(s)/guardian(s) hereby give consent to have the participant treated by a physician or surgeon in case of sudden illness or injury while participating in the above event. It is understood that the Organization provides no medical insurance for such treatment under its liability insurance coverage. The location of the activity or the nature of the illness or injury may require the use of emergency medical personnel. Participant and participant’s parent(s)/guardian(s) agree if any claim for personal injury or wrongful death is commenced against releasees, he/she shall defend, indemnify and save harmless releasees from any and all claims or causes of action by whomever or wherever made or presented for his/her personal injuries, property damage or wrongful death. Participant and participant’s parents/ guardian agree that the Waiver of Liability and Release is intended to be as broad and inclusive as permitted by applicable law and that if any portion is held invalid, all remaining portions will continue in full force and effect. Participant and participant’s parent(s)/guardian(s) acknowledge that they have been provided and have read the above paragraphs and have not relied upon any representations of releasees, that they are fully advised of the potential dangers and risks and understand these waivers and releases are necessary to allow the activities of the Organization to exist in its present form.Student Electronic Signature* I agree to the Electronic Signature policy.Electronic Signatures. If this Agreement has been signed with an electronic signature the parties hereto consent and agree to the use of such electronic signature with respect to this Agreement pursuant to the Electronic Commerce Act 2000, S.O. 2000, c17 as amended from time to time.Student Signature*Student Name* First Last Age*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Student Email* Student Phone*Upload a copy of your government issued ID (proof of age)* Drop files here or Select files Max. file size: 100 MB. Parent/Guardian Consent (if participant is under 18)*Parent/Guardian Signature (if participant is under 18)*Parent/Guardian Electronic Signature (if participant is under 18)* I agree to the Electronic Signature policy.Electronic Signatures. If this Agreement has been signed with an electronic signature the parties hereto consent and agree to the use of such electronic signature with respect to this Agreement pursuant to the Electronic Commerce Act 2000, S.O. 2000, c17 as amended from time to time.Upload a copy of Parent/Guardian government issued ID* Drop files here or Select files Max. file size: 100 MB.