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Consent to Release of Information and Liability Release
As a client of Midtown Assistance Center (MAC), you may receive services that require a third party company to complete (ex. pre-loaded MARTA cards). MAC uses third party vendors to provide some assistance, and MAC is not an agent of or affiliated with any of these companies in any way.
It may be necessary for MAC to provide a certain amount of your information such as your name and address to a third party in providing you with these services, including your landlord, employer or utilities companies.
By accepting these terms, you certify and agree to the following:
Limitation of Liability/Agreement not to sue: You agree not to sue, bring a claim for damages, or hold MAC liable or responsible, in any way, for any damages or harm that may arise out of your use of the Services. You further agree not to hold MAC liable for release of your information to third parties necessary to provide you with the Services. In no event will MAC be responsible for or liable for any claims or damages arising in any way from any act or omission or product of any third party vendor that MAC may utilize to provide the Services to you.
In order to provide the Services, MAC may have been required to agree to Terms and Conditions of third party vendors on your behalf. You authorize MAC to agree to any such Terms and Conditions on your behalf, if required by the third party vendors. You agree and acknowledge that you may be bound by any Terms and Conditions entered into on your behalf. You may request a copy of any Terms and Conditions that MAC has entered into on your behalf in order to provide you the Services.
You consent to release of your information by MAC, including to your landlord, utilities companies, your employer and vendors as necessary to complete services, provide follow-up and statistics, or guard against duplication of assistance.
You understand that by completing the forms as part of this request, you are providing information and requesting assistance, and completion of this request does not make you eligible for assistance. MAC will evaluate all requests individually and notify you of whether you are eligible for assistance. You certify that the information you have provided is true and correct. You also understand that if the information you provide is not true you will forfeit your ability to receive services from MAC.
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