Billet Agreement

Thank you for taking part in our Billet program. Please complete the following and submit:

* Indicates required field

Name *

First

Last

Email *

cell PHONE # *

I am ... *

IF Billet HOST, ADD Home Address *

Line 1

Line 2

City

State

Zip Code

Country

if billet host, list names and ages OF all PEOPLE IN the HOME *

Please note any preferences that will assist A21 to match students with Billet host family. This may include specifics such as: pets, food choices, religious affiliation, past times, personal interests, etc:

Notes: *

Section 1 - A21 Academy shall

1. Place Students with Billets based on the information student families and billet families share with A21 Academy, to best of our knowledge.

2. Provide assistance to both the Student and the Billets in resolving issues of mutual compatibility, behaviour, acculturation, and settlement in the community.

3. Provide ongoing support for Billets through orientation material and a thorough discussion of A21 expectations for the student’s home life experience. Billets can access A21 Administration 24/7 for emergency matters using the personal numbers provided upon approval.

I understand and agree to section 1 Type Initials: *

Section 2 - Billet host understands and agrees

1. A21 Academy prioritizes safety of students above all as our staff is dedicated to programming which meets educational and athletic goals of the Student.

2. Billets fees will either be paid through A21 Academy to billet familiy or directly by HomeStay to billet family, as agreed upon during the approval process.

3. A21 Academy does not issue T-slips for the purposes of income declaration; however, A21 Academy is obligated to report payments to hosts to the Canada Revenue Agency if asked. Billets are encouraged to consult a tax professional.

4. In the event that a Billets request that a Student be relocated, the Billet Family is required to forfeit or refund, as applicable, their unused Billet allowance (prorated as of the day of relocation).

5. With cause, students may change Billets at discretion of A21 Academy without giving notice or payment in lieu of notice, in which event the Billets is required to forfeit or refund, as applicable, their unused Billet allowance (prorated as of the day of relocation). Without cause, the Student or A21 Academy must provide his/her Billets with two weeks’ notice and the Billets are required to forfeit or refund, as applicable, their unused allowance (prorated as of the day following the two week notice period).

I understand and agree to section 2 Type Initials: *

Section 3 - Billets host must provide

1. Students with suitable accommodation, including a private room with a bed, desk, chair, closet, window, clean linens and towels, access to a bathroom and laundry facilities. A21 Academy Administration will visit the site before approval to ensure all is in order.

2. Provide the Student with a safe, secure, positive and emotioanlly stable home environment.

3. Speak English as the primary language in the home.

4. Provide supervision and guidance to ensure behaviour appropriate for the well-being of the Student in accordance with the A21 Academy guidelines herein:

A. Require school, school-related activities and hockey program attendance and guide the student to message A21 Head Coach before 8am with details of any necessary absence.
B. Prohibit posession, purchase and/or use of alcohol, illegal drugs and improper, objectionable, unsuitable or otherwise inappropriate or illegal substances or materials.
C. Follow the rules of the program, and the applicable laws of the municipality, province, and Canada.

5. Consider the unique requirements of billeting Minors. Billets will:

A. Assist the Student to learn how to access health services;
B. Supervise social activities and provide curfew times appropriate for the well-being and development of the Student as follows: All Students are expected to be home on or before 10:00 p.m. curfew daily unless billet parent receives written/text message approval from A21 Head Coach.
C. Provide (3) meals per day plus snacks. Two full meals to be sent to school and one at dinner hour. Supervise the Student’s eating, sleeping, rest and exercise activities to assist the Student in maintaining healthy living routines.
D. Monitor the Student’s school attendance, and behaviour while at the home and be available at all reasonable times by email or telephone to the Student’s school and/or academic advisor.
E. Monitor and limit the Student’s access and use of the internet and cell phone after 10pm curfew.
F. Limit travel outside the city or town without prior written permission of the Student’s Legal Custodian, natural parents and as appropriate from HomeStay.
G. Prohibit the driving of a motor vehicle or operation of a motorcycle or motor scooter or other motorized form of transportation, including watercraft, unless as part of a school-based and to not purchase, rent or otherwise arrange for the use of any such object. No use of any motorized vehicle is permitted without A21 Academy written consent.
H. Immediately inform A21 Academy of any problems, social or academic which arise.

6. Immediately inform A21 Academy in the event that:

A. The Billets decide to change residence, the home is listed for sale or renovations are initiated;
B. There are changes to the physical or psychological context of the home;
C. There are students from other programs residing in the home;
D. There are now, or may be in the future, other adults residing in the home such as tenants or family visitors who will stay overnight in the home.

7. Understand that the addition of other residents or students to the Billet’s home without the prior approval of A21 Academy could result in the removal of the Student without notice or compensation to the Billets.

8. Provide A21 Academy with evidence satisfactory to A21 Academy of a valid and legally compliant records check for all regular occupants of the home who are over the age of majority. The records checks must be current (less than one year old) and must be renewed every three (3) years. The costs of the provision of these checks are the responsibility of the Billets. In addition, the following requirements apply:

For Billets of minors, a Police Record Check and Vulnerable Sector Search (VSS) is required. This check can only be done in person at your local police or RCMP station. Please upload below.

9. Inform A21 Academy immediately if anyone in the home now or in the future:

A. is convicted of a criminal offence;
B. demonstrates violent behaviour;
C. is using illegal drugs and/or abusing alcohol;
D. has a minor removed from their care by the order of a court;
E. is disqualified from acting as a foster parent; and/or
F. is proven negligent whilst supervising minors under the age of majority on activities/courses

10. Inform A21 Academy immediately of any thefts that occur in the home or any damage to the home committed or caused by the Student. While a Student is responsible for any thefts or damage he or she causes, and A21 Academy will assist with the mediation of a dispute between a Student and the Billets, A21 Academy shall not be liable or responsible as regards any such theft or damage or for the provision of assistance in the collection of money for such theft or damage during or after the Student’s placement.

11. Ensure that:

A. Any medications are properly sealed and stored.
B. The emergency number “911” is posted close to all telephones and highlighted as such.
C. A fire extinguisher is present in the kitchen and near any wood stove or fireplace.
D. A fire escape plan is in place, is properly communicated to the Student, and that all exits are kept clear of obstruction.

12. Ensure the Student receives timely medical attention as appropriate and when required, including immediate medical attention where reasonably indicated, and that any medical or health concerns regarding the Student are reported promptly to A21 Academy.

13. Contact A21 Academy within two (2) hours if the Student is absent from the home without an explanation.

I understand and agree to section 3 Type Initials: *

Section 4 - Billet and Natural families agree

In accordance with applicable privacy laws, including those in force federally in Canada as well as in the province in which the placement is located, and including regulations, decisions, orders, judgments and rulings or regulatory requirements addressing privacy issues and/or the collection, use, transfer or disclosure of personal information, the Billets hereby consent to A21 Academy’s collection, use, transfer or disclosure of the personal information which the Hosts provide to A21 Academy, and in connection therewith understand and agree as follows:

1. A21 Academy collects personal information in order to:

A. Match the Billets with Students in the A21 Academy Billet Program;
B. Issue Billets allowance payments to Billets;
C. Contact the Billets regarding meetings, changes to policies or to communicate any other important information pertaining to A21 Academy Prep Program;
D. Collect statistics for the sole use of A21 Academy’s business development.

2. In the event the Billets are matched with a Student, A21 Academy will disclose personal information about the Billets to:

A. The Student with whom the Billets are matched, the Student’s parents or legal guardians, and, if applicable, the agent acting on the Student’s behalf in the Student’s country;
B. Third-party organizations that are also involved in the Student's stay in Canada. These organizations may include, but are not limited to, schools, school boards, placement agencies and tour companies.
C. Other Billets, in the form of a limited distribution list of Billets involved in a particular group, for the purpose of facilitating transportation arrangements (i.e. car-pooling) and/or to allow Students to contact each other during their stay.

3. Should the Billet withdraw their consent for A21 Academy to collect, use, transfer or disclose their personal information, their file will be removed from A21 Academy electronic system and all hard copies of their information will be destroyed.

4. The Billet have a right to see the personal information that A21 Academy holds, and the Billets agree to correct any inaccuracies in such personal information.

5. To uphold this Agreement;

A. That the information provided in the Billets Application and this Billets Agreement is true and complete to their knowledge, and that a false statement may disqualify them from providing accommodation to the Student;
B. To conduct him/herself in a moral and ethical manner in the presence of students staying in the household. They will not engage in any sexual conduct with the student or sexually harass or use their position of authority as an adult with the student in an inappropriate manner, and they will respect the privacy of the student;
C. To comply or to cause compliance, as the case may be, with the A21 Academy Guide for Billets, and all A21 Academy policies and procedures; and confirm, acknowledge and agree that they have each read, understand and fully accept all A21 Academy cancellation and refund policies;
D. That they have given their consent in this Agreement to A21 Academy collection, use, transfer and disclosure of the Billets personal information for the purposes of conducting A21 Academy business, as outlined in this Document;
E. A21 Academy is not responsible or liable for the actions of the Billets.
F. That they hereby waive, release and absolve and indemnify and save harmless A21 Academy in respect of which the Student is registered and all of those respective officers, directors, trustees, employees, representatives, agents, consultants and independent service providers (including but not limited to the transportation service provider(s) selected for the Student) from any and all liability for any and all of the actions, losses, damages and expenses (including, without limitation, the loss or theft of money, property damages or losses), personal injuries, or deaths, however caused. The undersigned Billets confirm that they, he/she have (has) had an opportunity to discuss this document with A21 Academy. The undersigned Billets understands any future changes made to the Billets Agreement will be deemed to have been signed. This agreement was drawn up in English as the express wish of the Host.

6. If students decide to travel, they must take all their belongings with them or store them in another location. It is not A21 or the billet family's responsibility to store personal belongings or ship them to students who eventually leave something behind. Please be advised that there may be costs associated with storage and or shipping if students do not vacate the property as expected. You can find storage lockers for rent in Windsor on the following website: www.findstoragefast.ca

7. Authorization, Release and Indemnity - I/we understand and acknowledge that the billets, staff, officers, employees and agents of A21 Academy act in the place and position of guardian of my child(ren) while in attendance at A21 Academy. Recognizing this, I/we authorize each or any of them to provide to my child(ren) any medical treatment and support that they consider to be reasonable or necessary.

In consideration of their willingness to care for my child(ren), I/we release, remise and discharge, indemnify and save harmless, the Billets, the A21 Academy Ltd, its Board of Directors, officers, employees and agents from any and all liability, claims or causes of action by virtue of application, or non-application of medical treatment and not liable for any accident or loss however caused. I/we agree to release A21 Academy from all claims and damages.

I have read section 4. Type Initials: *

I UNDERSTAND THAT BY TYPING MY NAME IS AN ELECTRONIC SIGNATURE, INDICATED THAT,I HAVE READ AND UNDERSTAND AND AGREE TO SECTIONS 1-4 OF THE A21 THE BILLET AGREEMENT:

Name *

First

Last

Billet Host - Please Upload Current Police Record Check *

Max file size: 20MB

SIGNED ON (TYPE DATE): *

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