INCOME AND STATISTICAL INFORMATION

 “Income” means the combined amount of money received each month by all people living in the house.  This information will remain confidential.

Authorization

I agree to present while the work is being completed on my home.

I am not presently planning to, nor do I intend within the next two years to sell my home.  I understand and agree to have my home rehabilitated by volunteers. 

I, the undersigned, certify subject to disqualification, that this information is true and correct to the best of my knowledge and belief, and that the provisions stated are accepted and agreed to.

In consideration of the opportunity afforded me to participate on a voluntary basis in the Brush Up Mac area home repair project, a project in which the homes will be repaired by volunteers, and in light of the aims and purposes of the community service provided by McPherson Housing Coalition, Inc in organizing this project, I waive any right or cause of action arising as a result of my participation in said project from which any liability may or could occur against McPherson Housing Coalition, Inc or its officers and directors collectively or individually. Without limiting the generality of the foregoing, I agree that this waiver shall include any rights or causes of action resulting from personal injury to me or damages to my property sustained in connection with my activities from the Brush Up Mac project. I agree to allow photos taken of myself while participating in Brush Up Mac to be published by MHC for publicity purposes.