Dominion Cares Foundation

Applicant

Service Information

Repair Needs

Financial Situation

Nomination Information (if applicable)

10. If you are nominating someone else, please provide their name and contact information:

Agreement

1. Purpose of Access:

The Owner hereby grants permission to the Foundation to access the property for the purpose of taking photographs, videos, and other media content during repairs being made to the Property. This content may be used for social media, marketing, and promotional materials by the Foundation.

2. Time of Access:

Access is granted until the completion of repairs.

3. Scope of Activities:

The Foundation may capture images and recordings of the Property, including but not limited to, interior and exterior views, work in progress, and any beneficiaries interacting with the repair process.

4. Ownership of Media:

All photographs, videos, and other media captured will be the property of Dominion Cares Foundation. The Foundation may edit, publish, and distribute this content for any lawful purpose, including promotional materials, social media, and press releases.

5. Confidentiality and Privacy:

The Foundation agrees to respect the privacy of the Owner and any residents of the Property. The Foundation will ensure that no identifiable personal information is disclosed without prior consent.

6. Liability:

The Foundation shall take all necessary precautions to ensure the safety and security of the Property and its occupants during the access period. The Owner agrees to release and hold harmless the Foundation from any claims arising out of the use of the Property for the purposes stated above, except in cases of gross negligence or willful misconduct.

7. Amendments:

This agreement may be amended only in writing and signed by both parties.

By signing below, I certify that the information provided is accurate to the best of my knowledge, and I understand that this application is for assistance from the Dominion Cares Foundation.