Agreement.
By submitting your application (the “Application”) for the ALGSAssistance Holiday Giving Tree Program (the “Program”), you hereby agree to these Terms and Conditions, which shall become a binding agreement (the “Agreement”) between you and the Alagille Syndrome Alliance (“ALGSA”) as of the date your Application is submitted.
Requirements.
The guidelines set forth on the Program flyer and on https://drive.google.com/file/d/1nNhgNC6hL6mI-DYBx46o04FWvL5F-Brm/view are incorporated into and made part of this Agreement. You must be 18 years of age or older to apply for the Program, and you must be currently receiving treatment for Alagille Syndrome, or be the parent or legal guardian of a child currently receiving treatment for Alagille Syndrome (an “Applicant”). An Applicant may apply for the Program as needed during the year, but an Applicant or an Applicant’s Immediate Family (as defined herein) will only be awarded Funds under the Program once. As used in this Agreement, “Immediate Family” includes the Applicant’s caregivers, spouse, parents, grandparents, children, grandchildren, brothers, sisters, mother-in-law, father-in-law, brothers-in-law, sisters-in-law, daughters-in-law, and sons-in-law, and shall apply regardless of whether such relationships occur through adoption, half-relations, or step-relations. You must certify your diagnosis in the Application, or if you are submitting an application on behalf of an Applicant, you must certify the Minor Applicant’s diagnosis of Alagille Syndrome in the Application. You may use a public social media page or other medical support website to confirm the diagnosis, or you may request that your healthcare provider send confirmation of the diagnosis directly to ALGSA using a medical eligibility form provided by ALGSA (please request this form by emailing alagille@alagille.org). The original invoice for which funding is sought must be attached to the Application. Funds shall be disbursed directly to the third-party payee, if such payee is located in the United States and has issued the invoice submitted with the Application (the “Payee”). If you are requesting continuation-of-care materials as outlined in this Program, please submit a photo or screenshot of the requested materials along with the associated costs.
Limitation of Program.
You understand and agree that the date and timeframe in which any funds disbursed in connection with the Program (the “Funds”) are issued cannot be amended or changed to fulfill a time-sensitive or overdue invoice. Receipt of the Funds should not be relied upon for emergency or urgent circumstances. ALGSA expressly disclaims any liability, damages, claims, or penalties, including late fees or damages due to cessation of services, caused by a failure of the Funds to reach the Payee within a specific timeframe or by a specific date, due to partial payment of amounts due, or for any other reason, including a delay in processing by the Payee. ALGSA further makes no guarantees regarding the date on which the Funds shall be received by the Payee.
Discretion.
ALGSA anticipates that it shall make up to fifty (50) $300 awards; however, ALGSA expressly reserves the right to award Funds and administer the Program in its sole discretion. ALGSA may discontinue or suspend the Program at any time, in its sole discretion and without notice to you.
Warranty.
You, on your behalf and on behalf of any Applicant, shall comply with all federal, state, and local laws, rules, regulations, and ordinances in connection with this Agreement, your Application, and any Funds. You further agree that the payment of Funds on your behalf or on behalf of any Applicant shall not violate any federal, state, or local law, rule, regulation, or ordinance, including, without limitation, laws governing the use and exchange of protected health information, privacy regulations, taxation, and copyright or trademark laws. You understand and agree that ALGSA makes no warranties or representations regarding any tax obligations incurred as a result of the Program or the Funds, and you expressly acknowledge that all withholdings, liabilities, and contributions shall be solely your responsibility or the responsibility of the Applicant. If submitting this Agreement on behalf of an Eligible Participant other than yourself, you expressly warrant and agree that you have authority and permission to submit such an application and that all information contained in the Application is truthful, accurate, and complete.
Grant of Funds.
You affirm that you have no business interests or activities that would conflict in any manner or degree with the Program or with the mission and purpose of ALGSA. ALGSA expressly reserves the right to terminate this Agreement immediately upon notification that you have engaged in conduct reasonably deemed to conflict with the mission and purpose of ALGSA, as solely determined by ALGSA, and no Funds shall be paid on your behalf. ALGSA reserves the right to request the removal of any public statements, including those on social media, at its sole discretion (“Public Statements”). You shall not post any Public Statements that may tarnish the reputation or goodwill of ALGSA. Among other remedies available to it, ALGSA expressly reserves the right to terminate this Agreement immediately upon notification that any Public Statements have been distributed in violation of this provision, and to obtain an injunction to prevent further dissemination of such statements, in addition to any other remedies available. If executing this Agreement on behalf of an Applicant, you hereby give your authority and permission for ALGSA to verify the relationship between you and the Applicant. You further give ALGSA authority and permission to contact any third party, including the Payee, to confirm the veracity of any materials submitted in connection with the Application or the Program.
Indemnification.
You, on your behalf and on behalf of any Applicants, your spouse, heirs, next of kin, assigns, executors, administrators, agents, successors, legal representatives, or any others who may claim on your behalf (collectively, the “Indemnifying Parties”), agree to indemnify, defend, and hold harmless ALGSA and its affiliates from and against any demands, actions, suits, damages, settlements, costs, liabilities, losses, claims, and expenses, including reasonable attorneys’ fees and costs, arising from: (i) the Indemnifying Parties’ negligence or willful misconduct; (ii) the inaccuracy or breach of any covenants, representations, or warranties contained in this Agreement; (iii) the issuance of Funds under this Agreement, including to any Payee; (iv) any tax liability, contribution, or payment assessed in connection with any tax obligation related to the Program and the Funds, including penalties and interest, if applicable; and/or (v) any other violation of any federal, state, or local law, rule, regulation, or ordinance, including, without limitation, claims of defamation or violations of copyright or trademark law. This provision shall survive the termination of this Agreement.
Termination.
ALGSA may terminate this Agreement at any time with five (5) days’ prior written notice to you.
Release and Waiver.
By submitting the Application and entering into this Agreement, you, on your behalf and on behalf of any Applicants, your spouse, heirs, next of kin, assigns, executors, administrators, agents, successors, legal representatives, or any others who may claim on your behalf (collectively, the “Releasing Parties”), hereby forever waive and release ALGSA, and its owners, employees, trustees, contractors, volunteers, representatives, agents, assigns, successors, and anyone else acting on its behalf (collectively referred to herein as “ALGSA”), from any and all liability, present, past, or future, relating to, connected with, or arising out of the Program, the disbursement of any Funds, and this Agreement. The Releasing Parties promise not to sue, and hereby irrevocably waive, release, and discharge ALGSA from any and all liability, claims, demands, actions, or damages of any kind related to, arising from, or in any way connected with the Program, any Funds, or this Agreement. This Release and Waiver applies to all claims, demands, damages, costs, expenses, actions, and causes of action, foreseen or unforeseen, including but not limited to negligence or breach of statutory duty. The Releasing Parties understand and agree that this Release and Waiver is intended to be as broad and inclusive as permitted by law.
Permission to Use Likeness/Name.
You, on your behalf and on behalf of any Applicant (collectively, “You”), expressly grant ALGSA the right to use your name, appearance, image, likeness, voice, identity, picture, or personal story, or those of any Applicant (together, the “Likeness”), in any manner in connection with ALGSA’s business (including, without limitation, for purposes of advertising and trade). You release all rights of publicity, editorial rights, and other related rights with respect to the Likeness in connection with ALGSA’s business and acknowledge that You will not receive any compensation for ALGSA’s use of the Likeness.
Waiver of Breach.
None of the terms of this Agreement shall be deemed waived or modified except by a written document executed by ALGSA and you. Failure or delay by either party to enforce any of its rights under this Agreement shall not be deemed a modification or continuing waiver of any rights under this Agreement.
Entire Agreement and Severability.
This Agreement constitutes the entire agreement between you and ALGSA. In the event that any provision of this Agreement is held to be invalid or unenforceable, such invalidity shall not affect the validity or enforceability of the remaining provisions. The Program is void where prohibited by law.
Governing Law.
This Agreement shall be governed by and construed in accordance with the laws of the State of Oregon, excluding its conflicts of law principles. Any disputes arising hereunder shall be brought in a venue within the State of Oregon.
I am 18 years of age or older, and I expressly warrant and agree that all information contained in the Application, including any invoices or diagnosis confirmations, is truthful, accurate, and complete. I have read the Application and the Terms and Conditions in their entirety, including the release contained herein, and I fully understand their contents, meaning, and effect. I have not obtained payment from any other source for the invoice(s) submitted. I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to signing, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.
