I verify that I am at least 18 years old.

I acknowledge that upon acceptance of my Registration Application by Care Hearts Ally. "This Agreement establishes that I am registered on the directory platform as a service provider and independent contractor, not an employee, and will be solely responsible for my own taxes, benefits, and work hours, with no right to employee benefits like vacation or sick leave; in exchange for providing services to clients, the Company will compensate the Contractor at payment rate on a payment schedule."*

I acknowledge that the information I have provided on this Registration Application is true and complete and will be verified. I understand that any falsification or omission of information on this Registration Application or during the interview process, no matter when discovered, shall constitute grounds for denial of my acceptance as an independent contractor and service provider and immediate termination of the contract agreement.

Upon exceptance of my Regeristration Application as a independent contractor and service provider. I agree that as a service provider I am required to submit copies of my valid driver's license, full coverage auto insurance, current vehicle registration and state inspection.