REFERRAL FORM

I accept responsibility for any and all damages caused to Quantum House or its contents by me, a member of my family or my guests.

I understand that I enter Quantum House at my own risk and that Quantum House is not responsible for my possessions or any 

personal injury to me, any member of my family or my guests.

If I violate any of the rules and regulations, I understand I will be asked to vacate Quantum House, and I forfeit my privilege to stay at

Quantum House in the future.

I understand I am here for my child(ren) and I will not be receiving medical treatment for myself as a caretaker.

I understand that my child(ren) cannot be left unattended at any time while at Quantum House.   

I understand alcohol, illegal drugs and smoking are NOT permitted in Quantum House or on the St. Mary’s campus at any time.

I understand that Quantum House does not provide maid service and I am responsible for cleaning my guest suite daily and at check

out.

I will be expected to thoroughly dust, vacuum & clean my entire guest suite including wash my own linens on a weekly basis.

A valid driver’s license or valid photo ID is required for each guest in the house and will be kept on file.

At check out, I am expected to return the room to its original condition with the exception of the linens. Dirty linens should be left

inside the laundry basket in the room.

Background checks may be run on potential House guests prior to being accepted as guests.

No solicitation of any kind is permitted while staying at Quantum House.