The applicant agrees that he or
she has been fully informed of the risks, has had an opportunity to ask
questions and understands that Intercultural Homestays and Services, Inc.
cannot maintain supervision over the internal Homestay / apartment /
dormitory environment. The applicant acknowledges that injury or death may
arise while residing within a home in an American neighborhood. I accept
full responsibility for my possessions, my actions in so far as I will not
hold Intercultural Homestays and Services, Inc. or my Host responsible for
loss, illness or death. I assume full responsibility for all medications I
take.