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Entry Date Resident Agreement - Fresh Start Sober Living
3 Tenant Release Agreement The following terms and agreement are to be

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Entry Date Resident Agreement - Fresh Start Sober Living

3 Tenant Release Agreement The following terms and agreement are to be read and fully understood by the undersigned tenant of the Fresh Start

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File name: FSSL_ResidentAgreement.pdf


	 
                                                          
 
 
 
-
 
1
 
-
 
 
Resident 
A
greement:
 
 
 
 
 
 
Full Name
 
(First,Middle,Last) 
:
 
________________________________
________________________________
____________________
 
 
Present Address:
 
________________________________
________________________________
_______________________________
 
 
Previous Address: 
 
________________________________
________________________________
______________________________
 
 
Home of Record:
 
________________________________
________________________________
_______________________________
 
 
Date of Birth: 
______________________________________   SS#:
 
________________________________
______________________
 
 
ID/
Driver’s License (#/State):
 
________________________________
________________________________
_____________________
 
 
____ Verified Initials (House Manager/Program Director)
 
List Family Member
(
s
)
:
 
________________________________
________________________________
__________________________
 
 
List Family Member
(s)
 
Contact #:
 
________________________________
________________________________
__________________
 
 
List your Present Employer:
________________________________
________________________________
_______________________
 
 
Employer Address:
 
________________________________
________________________________
______________________________
 
 
Employer 
Supervisor/
Contact Person:
 
________________________________
________________________________
______________
 
 
Emergency Contact/Relationship:_______________________________________  Contact Phone:
 
____________________________
 
 
Have you ever been convicted of a crime?    _____ 
Yes
  
_____ 
No
     
(
If Yes, 
Please explain below)
 
 
________________________________
________________________________
________________________________
_____________
 
 
 
________________________________
________________________________
________________________________
_____________
 
 
Are you presently in the legal 
system?   _____
Yes
  
_____
No
    
(
If Yes, 
Please explain
 
below
)
 
 
________________________________
________________________________
________________________________
_____________
 
 
 
________________________________
________________________________
________________________________
_____________
 
 
List any 
(current) 
Parole or Probation Office
r
s and contact numbers:
 
 
________________________________
________________________________
________________________________
_____________
 
 
Are you addicted to drugs and/or alcohol?   _____
Yes   _____No
    
(
If Yes, 
Please explain
 
below
)
       
Sobriety/Clean Date: 
 
__________
 
 
 
________________________________
________________________________
________________________________
_____________
 
 
Have you ever been in a Treatment Facility?    _____ 
Yes
  
_____
No
    
(
If yes, 
Please explain
 
below
)
 
Entry Date ___________________________________
 
 
                                                          
 
 
 
-
 
2
 
-
 
 
 
________________________________
________________________________
________________________________
_____________
 
 
Are you taking any prescripti
on medications?    _____Yes 
  
_____ 
No
    
(
If Yes, Please l
ist all medications below and reas
on)
 
_
 
________________________________
________________________________
________________________________
____________
 
 
_
 
________________________________
________________________________
________________________________
____________
 
 
________________________________________________________________________________________________________________________
 
ALL MEDICATIONS ARE TO BE 
KEPT SECURED IN A LOCKED SAFE/BOX.  RESIDENTS ARE 
INDIVIDUALLY RESPONSIBLE FOR THE PROVISION OF HIS
/HER OWN SAFE/BOX.
 
Have you ever been in a Recovery House, Halfway Hous
e or similar facility?    _____Yes  _____No
    
(If 
Y
es, explain when
/
where)
 
 
________________________________
________________________________
________________________________
_____________
 
 
Do you have a Sponsor?    _____
Yes
  
_____ 
No
    
If Yes, 
Sponsor’
s Name/
#:
 
________________________________
________________
 
 
Please read and initial 
to 
indicate your understanding and agreement
:
 
____
 
The 
Fresh Start 
Sober Living
 
program requires a 
$
259
.00
 
a
dministrative entry 
fee
. 
 
____
Rent
 
is 
$1
29
.00
 
week
ly or 
$
559
.00
 
monthly. Rooms are rented by the week/month only. 
Residents
—
specifically those in 
arrears
—
can make daily m
onetary payments 
in
 
any 
sum/
amount
.
 
To make a payment, see house manager and ensure receipt is 
provided. 
Each week begins on Sunday and ends on Saturday. A rent arrearage 
can/will
 
result in eviction. 
Provided a client departs 
sober 
and in good standing (i.e., packs and carries his
/her
 
own belongings the day he
/she
 
departs, washes and places linen back 
on his
/her
 
bed, cleans his
/her
 
/she
 
is likely to 
r
eceive a refund of any overpayment; anything less will result in a pro
-
rated refund or no refund at all. All refunds are given at the 
Fresh Start Sober Living
. Departing clients must allow at least (14) days for the processing of any refund.
 
____
Incentive
; every client that resides in the 
Fresh Start 
Sober Living
 
pro
gram 
sober and in good standing
—
for (26) consecutive 
weeks
—
is entitled to a 
$5.00
 
per week 
credit
 
for each of the (26) weeks (
$130.00
). If the client was sponsored into the 
Fresh Start 
Sober Living
 
program it may be suggested and/or necessary to pay back any money initially provided them. The client would then be 
entitled to the difference, if any, in that which is owed the sponsoring entity and $130.00. 
 
____I realize that t
he 
Fresh Start 
Sober Living
 
program for which I am applying for residency requires complete abstinence from 
Drugs and/or Alcohol. Any use of Drugs and/or Alcohol is strictly prohibited and 
will
 
result in immediate eviction from our 
residence(s). Disruptive and/or Discourteous behavior within our residence(s) or community 
will not
 
be tolerated and 
can/will
 
result in 
eviction from our residence(s). Finally, a client’s inability to maintain employm
ent and pay his
/her
 
rent in a timely 
manner 
can/will
 
result in eviction from our residence(s). 
By initialing/signing, I acknowledge agreement to the terms stated, and 
hereby waive my right(s) to normal due process afforded by local landlord
-
tenant laws.
  
 
____I have read all the material on this application, and answered each question honestly. I have a 
sincere
 
desire
 
to live 
Clean 
and/or Sober
, and achieve comfortable recovery from alcoholism and/or drug addiction without relapse. Any questions I may have 
had wer
e answered to my satisfaction. 
 
 
Signature: ________
_____________________________________________          
Date: __________________
____
 
Witness: ________
______________________________________________
 
 
                                                          
 
 
 
-
 
3
 
-
 
 
Tenant
 
Release Agreement
 
 
The following 
terms and 
agreement 
are to be 
read and fully understood by the undersigned tenant of the Fresh Start, 
LLC program.
 
1.
 
 
Fresh Start
 
Sober Living
, LLC is providing the undersigned tenant, _________
____________
__________, a place 
to reside
 
in their sober living facility located at ____________________________
______
__________ in return 
for 
a 
contracted rental fee.
 
2.
 
The undersigned understands that they shall live in the facility under the agreed upon contractual terms and 
rules as provided an
d explained, and may terminate their residence at any time.
 
3.
 
Fresh Start
 
Sober Living
, LLC is providing a sober living facility only and does not provide any counseling, nor 
restrict the undersigned from making their own personal choices as long as they do 
not violate facility rules as 
outlined in their contract for residence.
 
4.
 
Fresh Start
 
Sober Living
, LLC will provide a housing facility in normal condition, and shall not be held liable by the 
undersigned for any injury or loss to the tenant, or their belong
ings. The undersigned, by and through their 
signature, acknowledges that they are responsible for any injury or accident and will forever hold harmless Fresh 
Start
 
Sober Living
, LLC unless said provider is negligent in the cause of the loss.
 
5.
 
The undersigne
d understands that Fresh Start
 
Sober Living
, LLC carries only insurance to cover the dwelling and 
business assets located in the dwelling. 
 
6.
 
The undersigned will immediately notify Fresh Start
 
Sober Living
, LLC, in writing, of any incident resulting in 
inju
 
 
 
Signed and d
ated this ____________ day of 
_____________
_____, 20
 
_______
 
.
 
 
FOR RESIDENT:
 
________________________________
____________________
 
 
 
                             
Print 
Name
 
________________________________
__________
 
 
 
 
FOR FRESH START, LLC:
 
________________________________
_____________
 
 
                               
            
Michael Gillis
, Founder & CEO
 
 
 
 
 
                                                          
 
 
 
-
 
4
 
-
 
 
General 
House 
Rules/Requirements/
Guidelines:
 
You are in a Sober Living Program
/Environment
.
 
Your success and continuance in this program
/environment
 
is 
dependent upon your consistent good behavior and cooperation. Disruptive and/or Discourteous behavior 
will not be 
tolerated
. Any contact with Illegal Drugs and/or Alcohol and
/or
 
violation of any of the following Rules & Guidelines 
can/will
 
result in ev
iction. Your initials and signature indicate your understanding and agreement. When in 
doubt͙ASK!
 
 
____
 
Consumption or possession of 
beverage 
alcohol in any form is strictly prohibited.
 
 
____
 
Use or possession of illegal drugs in any form is strictly prohi
bited.
 
 
____
 
Use and/or possession of drugs and/or alcohol 
will
 
result in
 
immediate
 
eviction. If evicted for drugs 
and/or 
alcohol the 
resident
 
agrees to leave the premises immediately 
and 
not return for any reason 
whatsoever, 
without permission from the 
House Manager and/or Fresh Start Sober Living
.
 
 
____
 
Lying, Cheating & Stealing are strictly prohibited. 
If caught, you 
will
 
be fined and/or evicted.
 
 
____
 
Residents are
 
required to submit to a Drug and Alcohol Screen/Test at any 
time (24/7) it 
is requeste
d
. 
A r
efusal 
and/or failure to provide an adequate sample will be treated the same as a 
positive test result.
 
Any attempt to 
Cheat/Circumvent test 
will
 
result in
 
a
 
fine/eviction.
 
 
____
 
Daily attendance at “12 Step” meetings is 
strongly 
encouraged/
recommend
ed
; the minimum 
daily attendance 
requirement is (
5
) 
per 
week.
 
Acceptable meeting attendance is seated & present prior to the Serenity prayer, 
present for all readings
 
as well as 
the meeti
ng itself up until and after the 
Lord ’s Prayer
 
is concluded
. ARRIVE 
EARLY, STAY LATE!
 
MEN WITH MEN, WOMEN WITH WOMEN!
 
 
____
 
Residents are
 
required to maintain a Home Group.
 
 
____
 
Residents are 
required to maintain a working relationship with a Sponsor. It is recommended that 
each 
Resident 
be on track
 
to take all 
“12 Steps”
 
within 
6 
–
 
9 months from date of arrival 
at 
Fresh Start
 
Sober Living
. 
 
 
____
 
Residents are
 
required to maintain empl
oyment. If at any time a client 
is/
becomes unemployed 
and is capable 
of working (not injured or sick), he
/she
 
must actively seek employment from 
8
:00 am 
-
 
5:00 pm Monday through 
Friday
,
 
and is not permitted at the house during this time.
 
A resident’s e
mployment 
is 
prohibited from 
interfering
 
with 
their 
a
dherence to 
any
 
of the 
other 
terms of this agreement.
 
 
 
____
 
Behavior considered to be a 
“Conflict of Interest” (i.e., 
Sponsorship, 
Employment
) 
Residents
 
is strictly prohibited
.
 
NO DATING
 
OR VISITATION
 
NTS
/HOMES
 
OF FRESH START 
SOBER LIVING WITHOUT PERMISSION from Mr. Gillis.
 
 
___
_
 
Smoking inside 
any Fresh Start Sober Living home is strictly prohibited.
 
 
____
 
F
resh Start Sober Living 
is 
NOT (at any time) 
responsible 
for a resident’s personal 
item’s/
belonging(s)
. 
Residents 
are responsible for the security and safekeeping of their own personal item’s/belongings and are 
to pack 
and 
carry their 
item
’s/
belongings when 
they depart. If for 
any 
reason this does not occur
,
 
the 
Resident 
may contact 
 
                                                          
 
 
 
-
 
5
 
-
 
 
the 
House Manager or 
Fresh Start So
ber Living
 
regarding the 
disposition 
of their
 
personal 
item’s/
belongings. Fresh Start Sober Living
 
will not 
store personal 
belongings for more than
 
seventy
-
two
 
(
72
) 
hours.
 
 
 
____
 
Disruptive/D
iscourteous 
b
ehavior will not be tolerated and 
can/will
 
result in eviction.
 
 
__
__
 
Guests of the opposite sex are strictly prohibited
 
from entering any Fresh Start Sober Living home
.
 
 
____
 
Overnight guests are strictly prohibited.
 
 
____
 
Guests are not permitted at the house beyond curfew
 
and are only permitted 
in the common areas
.
 
 
 
____
 
Guests cannot be under the influence or in possession of drugs and/or alcohol.
 
 
____
 
New 
Resident
 
curfew is 
6:00pm
 
every night.  A
ll others must be in by 1
0
:00 pm Sunday through Thursday and 
11:00 pm
 
Friday and Saturday. 
Residen
ts
 
must adhere to more strict curfe
ws when required (i.e., Parole, 
can/
will
 
result in 
eviction.
 
 
____
 
to
 
5
:00a
m. Any activity (i.e., 
L
ights, 
TV, 
T
elephone conversations, etc.) that disturb 
another 
residents
 
ability to 
sleep/
rest 
is prohibited. 
 
 
____
 
E
victed 
Residents are
 
required to leave th
e premises immediately and not 
 
 
____
 
Residents of 
Fresh Start Sober Living ar
e 
discouraged from maintaining relationships with those evicted from the 
Fresh Start Sober Living program. 
  
 
 
____
 
House 
Business 
Meetings are held weekly at 
and are mandatory for every 
c
lient
.
 
An unexcused absence from any House Business Meeting can/will result in a 
fine, or eviction.
 
 
____
 
Overnight/Weekend Passes are to be submitted to the House Manager
 
a minimum of 
(1) week in advance. 
Authorization will be granted at the 
Hous
e Manager and Fresh Start Sober Living.
 
 
____
 
Residents
 
are not permitted in any bedroom other than their own without permission from the 
resident(s) 
residing in that room; they must also be accompanied by the permitting 
resident
.
 
 
____
 
Thermostat is to be
 
adjusted by the House Manager only.
 
 
____
 
Washer & Dryer
 
--
 
Be courteous. Clean dryer lint screen 
before 
and after every use and do not leave clothes 
unattended in the washer/dryer.
 
 
____ 
 
daily. The House Manager is 
responsible for chore assignment and 
 
 
 
____
 
A 
good General Clean
-
up of all areas
 
inside & outside the home is required 
at all times.
 
 
 
                                                          
 
 
 
-
 
6
 
-
 
 
____
 
Beds are required to be made upon awa
kening.
 
Respective areas are to be kept neat, clean and picked up at all 
times. NO SLOBS; YOU 
CAN/WILL
 
BE FINED!
 
 
____
 
Telephone
 
—
 
15
-
minute time limit per hour. Be courteous and pass along messages.
 
 
___
_
 
 
Turn off lights, TV’s, Radio’s, Fans, etc., when 
not in use. Exterior doors are required to be locked 
when 
entering/exiting; no exceptions!
 
 
 
____
 
Residents are required
—
at all times
—
to wear appropriate dress in 
common areas.
 
 
____
 
Sleeping 
in common areas is prohibited.
 
 
____
 
Kitchen
—
Appliances, Counter
-
tops, Utensils, Dishes, Pots, Pans, etc. will be cleaned and returned to their 
respective place 
(
immediately
)
 
after 
each 
use.
 
 
____
 
Refrigerator
—
Mark
 
food/leftovers with Name/Date when initially placed in the refrigerator.
 
 
____
 
Fresh Start Sober Living residents
 
are not permitted on any othe
r property within the community 
without 
permission
 
from the owner of the property. 
Additionally, the Fresh Start Sober Living resident must
 
be 
accompanied by the property owner. 
 
 
____ 
 
All p
rescribed M
edication
(
s
)/controlled substances
 
Any 
resident caught using/possessing any prescribed Medication/controlled substance unknown to the House 
Manager or exceeding (1) days dosage of prescribed m
edication/controlled substances 
will
 
be evicted! 
 
 
____
 
Be Accountable/Responsible and Communicate! Accountability, Communication eliminates need for escuses 
with House Manager
 
 
____
 
A violation of
 
any one of 
the aforementioned 
Rules & Guidelines 
can/will
 
result in a 
fine
 
or eviction
. Fines 
range 
from 
as little as 
$
2
5.00, 
up 
to 
a full $1
25 (the equivalent of an entry/reentry fee).
   
 
 
 
Signature: ___________________
____________
________ Date: ___________________
, 20___.
 
 
 
Witness: _____________
___________
________________
 
 
                                                          
 
 
 
-
 
7
 
-
 
 
New Resident
 
Status
 
 
Resident’s
 
Name: ______________________________________
_________
 
 
Every 
“
new resident
”
 
entering the 
Fresh Start Sober Living
 
Program and those
 
residents
 
that violate the conditions of 
their agreement with 
Fresh Start 
Sober Living
 
are placed on “new 
resident
” status. The 
Fresh Start Sober Living
 
Program 
requires strict adherence to these conditions and all Rules & Guidelines. While on “new 
resident
” status, you must:
 

 
Attend an AA/NA 
meeting daily 
& 
get 
a 
meeting sheet 
signed
.
 

 
Have a Sponsor (
Residents are required to maintain a working relationship with a Sponsor. It is 
recommended that each Resident be on track to take all “12 Steps” within 6 
–
 
9 months from date of arrival 
at Fresh Start Sober Living
)
.
 

 
Have
, attend an
d participate in a 
Home Group
.
 
 

 
Have 
and fulfill 
a Service commitment
.
 

 
Adhere to a 6:00
 
pm 
curfew (If attendance at
 
an 8:00pm “AA/NA
” meeting 
is desired, 
you may leave 
at 7:15 
pm and return no
 
later than 9:
45
pm and must attend with another 
Fresh Start
 
Sober Living
 
resident
)
.
 

 
Be employed and/or have satisfied all financial obligations
.
 
(Any 
resident
 
in financial arrears is re
sponsible 
to pay rent 
of
 
$17
.00 per day
,
 
and 
is 
not allowed to possess 
their
 
Cell Phone and/or
 
Vehicle while in 
arrears)
.
 

 
Satisfy a
ll conditions of your agreement with 
Fresh Start
 
Sober Living.
 
(A client will remain on 
new 
client
 
status until all conditions of his
/her
 
agreement with 
Fresh Start Sober Living
 
are 
satisfied. If at any time 
a client violates the conditions of his
/her
 
agreement with 
Fresh Start Sober Living
, 
he
/she
 
will 
automatically 
be 
placed 
on 
“new resident”
 
status.  
 
 
Note: You are encouraged to become thoroughly familiar with 
all Rules & Guidelines and 
the conditions of your 
agreement with Fresh Start 
Sober Living. 
Ignorance is not an excuse! 
 
 
Client 
Signature: ___________
______________________________                     
Date: ________________
, 20____
 
 
Witness:
 
______________________________________
_________
 
 
                                                          
 
 
 
-
 
8
 
-
 
 
Drug Screen/Test
 
 
I 
___________________________________, understand that I can be tested for Drugs and/or Alcohol at any time
, for 
any reason,
 
per my agreement with 
Fresh Start Sober Living
. I am aware and have full knowledge that the person(s) 
administering the test(s) are m
y peers and not medical personnel. I am als
o aware that if I test positive, 
refuse 
compliance
 
or attempt to cheat/circumvent the test in any way,
 
I 
will
 
be evicted from the 
Fresh Start Sober Living
 
program and required to leave the premises immediately. My
 
signature below indicates my 
understanding and 
consent.
 
 
 
Signature
 
________________________________
___________
 
 
 
Date
 
________________________________
__
 
 
 
Witness 
 
________________________________
____________
 
 
 
Witness 
 
________________________________
____________