Membership Agreement

Click here to download this agreement and email back to Capital City Village!

Capital City Village (CCV) is a nonprofit 501(c)(3) corporation, founded by residents in Austin, TX and serving members with Austin addresses. CCV’s goal is to help its members live life to the fullest in their own homes and communities as they grow older. CCV has established and is continuing to develop a network of volunteers, social and cultural activities, and service providers that offer a full range of services to members to enable them to age in place.

Individuals and households become members of CCV by applying and qualifying for an applicable level of membership based on income. The nonprofit corporation is managed by its Board of Directors; subscribing members are not voting members of the corporation. Membership begins the day you pay your fee, and will continue for twelve consecutive months. Payment plans are accepted and arranged with Capital City Village staff.

Members subscribe to and receive the services CCV provides. Capital City Village acts on behalf of its membership to identify the activities and services the Board has determined to be most needed by and most beneficial to its members. CCV relies on volunteers and also identifies strategic partners who deliver such activities and services in the geographic area served at convenient times and places.

Most of the activities of CCV will be available at no additional cost. As a CCV member, you will contract directly with and be billed for services by third-party service providers; these service providers will offer in some cases discounts to CCV members.

CCV is committed to ensuring member satisfaction with the activities and services provided. CCV, however, will not under any circumstance assume any direct or indirect responsibility or liability in connection with services contracted for by members with third-party providers identified by CCV.

Member Recruitment and Acceptance/Declination Policy

Capital City Village, its staff, board and committees, make no promises, guarantees or declarations regarding terms of services or delivery of service beyond those outlined in the membership agreement and/or CCV official public documents. Each potential member must be advised of membership fees, methods of payment available, anonymity with regard to membership fee paid, and process for applying including the review of each application, prior to completing the membership agreement.

Capital City Village reviews every application for membership upon receipt. Every membership will be deemed as provisional until the Membership Committee or staff have visited in person by phone and/or in home (also known as a “home visit”) with the individual/household who is applying for membership. Capital City Village has the final right of acceptance or refusal of any applying member.

Upon acceptance of membership, the member will be contacted by the Capital City Village office via phone, email or letter with an official confirmation and welcome outlining details of membership, including but not limited to: fee paid, how to request services, the limit of 2 services available per week, the events calendar, receiving the newsletter, requesting provider referrals.

Capital City Village reserves the right to decline the membership of any individual or household including but not limited to any of the following circumstances: the individual/household is not living independently; the individual/household has moved out of CCV's scope (Austin, TX address); CCV determines the individual/household requires services beyond the scope that CCV can provide; and/or the individual/household will require more than 2 services per week in order to continue to live at home and has no other means to secure these services outside of Capital City Village.

All terms and policies are subject to change.

Agreement: In order for Capital City Village to assess and evaluate its members’ needs and levels of satisfaction, I authorize service providers to share non-medical data with CCV about the services I use. CCV reserves the right to be in touch with a member's contact person(s) when health or safety concerns arise. INITIAL HERE:

_____ (Member 1) _____ (Member 2) _____ (Member 3)

As a Capital City Village member to the extent permitted by Texas law, (i) I hereby release and discharge Capital City Village from all responsibility or liability for services rendered by any service providers, and (ii) I agree to hold Capital City Village harmless from and against any cost, expenses or damages (including without limitation, reasonable attorney's fees) arising in connection with any and all claims brought by or through me, including but not limited to claims brought by my insurance carrier. INITIAL HERE: _____ (Member 1) _____ (Member 2) _____ (Member 3)

Please click here to download the full form, which includes membership levels and details.