YOUR PERSONAL EMERGENCY-DEVICE

Only 3 steps to reserving your personal Emergency-Device

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! If you would like to send us your Reservation by FAX click on the "download button". Otherwise, continue by clicking on the "next step button". (The Fax-Number can be found on the Reservation Form)

Please Note:

The minimum billing period is 7 (seven) days and please allow a minimum of 24 hour for set-up.

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iMergencies - ECDE International, Lda.

Please Note:
The minimum billing period is 7 (seven) days and please allow a minimum of 24 hour for set-up.
A rental of the Alarm-Button Unit for 31 to 60 days receives a 10% discount; a rental period of 61 days to 90 days receives a 20% discount; and, a rental period of 91 days or more receives a 30% discount.

Reservation Personal Emergency-Devices

My holiday-accommodation and reservation

Accomodation *

Reservation from *

To *

Rental costs and Deposit

Days

Rental costs in €

Deposit in €

Total in €

Personal details and medical information

My personal details

Title *

First name *

Last name *

Address *

City *

ZIP code *

Country of origin *

Date of birth *

Passport No. *

Mobilephone No.

Email *

Emergency Contact phone

My medications

Allergies (400 chars left) - Penicillin - Bees - Wasps *

Medications (400 chars left) - Simvastatin 25mg - Metoprolol 50mg - Aspirin Cardio 100mg - Nurofen 400 - Paracetamol 250mg - Cortisonil 100mg - Taxofit magnesium 400mg *

Additional information (400 chars left) - Hip replacement - artefical right hand - Appendix removed 1999 - 3 Stents 2007 *

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Terms and Conditions

The following are the Terms and Conditions that apply to the rental of the Emergency Alarm Button Unit from ECDE International’s iMERGENCIES Group.
Please read them carefully before submitting your application and reservation form. “We” or “us”” represents ECDE International and any of its entities. “You” or “your” refers to the Emergency Alarm Button renter.

0) DOMAIN
The Emergency Alarm-Button Rental Agreement, once fully executed (upon your acceptance of the Emergency Alarm-Button Unit at hotel Reception) pertains to any emergency that occurs while you are outside of the Hotel property and is the sole responsibility of ECDE International.

1) RENTAL START DATE
The starting date of your rental will be the date you requested the unit as per the online Reservation Form. This date will be the first day when determining the billing period. This date must be at least 24 (twenty-four) hours later than the date of this reservation.
2) RENTAL DURATION
The rental period will begin on the Start date requested on the online Reservation Form and end on the last day indicated on the online Reservation Form. The minimum billing period is 7 (seven) days. Extension of the length of the rental period can be initiated at any point prior to the end date by contacting the iMERGENCIES Operations Center +351 707 910 058.

3) RETURN DATE
The Return date is the date you must return the Alarm-Button Unit to the location at which you received it. This will be the last day when determining the billing period.

4) LATE FEE
If the Unit is returned later than indicated on this Form there will be a Late Fee charge equivalent to one additional term the original Agreement is based on, i.e., days or weeks.

5) SECURITY DEPOSIT
There will be a pre-authorization notation to your credit card during your rental term. This deposit authorization will not appear as a charge on your account nor will it affect your credit card balance.You are responsible for inspecting the Alarm-Button Unit and signing as to the presence of all components (as indicated in this Agreement) and their condition. If the Unit is returned on time and in the same condition as it was received by you, the deposit authorization will be released. If the Alarm-Button Unit is returned damaged or later than the Agreement Return Date, the appropriate fee will be charged to your credit card.

6) INTENDED USE
The Alarm-Button Unit (Device, Charger and USB-Cable) is intended to be used by you in an emergency situation when you are no longer on the hotel premises/property. It is intended to be used only for this purpose. We are not liable for any damages that may occur to you or a third party that occurs as a result of the use of the Unit for any other than its intended use.

7) YOUR RESPONSIBILITY
You are responsible for returning the Alarm-Button Unit in the same condition it is received on the date indicated in this Contract. You are also responsible for protecting the Alarm-Button Unit from theft, fire, water, weather and other potentially damaging events.

You are responsible for notifying us if damage of any kind occurs to the Alarm-Button Unit regardless of cause, including normal wear and tear. The Alarm-Button Unit can only be serviced and/or repaired by us, or, a party authorized by us.

8) YOUR LIABILITY
You are liable for any and all damage to the Alarm-Button Unit (Device, Charger and USB-Cable) whether by intent, improper use, negligence or use by an unauthorized person. In the case of damage to any component, you will be responsible for paying the relevant list price for that component. The relevant list price for a component will also apply in the case of the loss of any component.

9) FAILURE TO PICK-UP
If the Contract is executed, but, the device not picked-up, you remain responsible for payment of the Contract amount.

10) EARLY RETURN
If the Alarm-Button Unit is returned prior to the end date indicated in the Contract you remain responsible for the full term defined in the Contract.

11) IN CASE OF DAMAGE
In case of damage, you will be responsible for payment of the Contract and repair of the device or component(s) only if you were responsible for the damage. We will provide a replacement device or component(s) for the duration of either the Contract or the repair.

12) TERMINATION
We can terminate the Contract at any time if it is determined that you have misused the Alarm-Button Unit. In the event of such termination of the Agreement, we have the right to reclaim the Unit immediately.

13) FAILURE TO PERFORM
We cannot be held responsible for failure due to events beyond our control, i.e., communication network failure.

14) LEGAL VENUE
Any judicial actions relating to this Contract will occur in the appropriate court in Portugal.

15) INVALIDATION
If any provision of this Contract is found to be invalid, all other provisions remain valid.

16) ACCEPTANCE
When the Alarm-Button is presented to you, it is your responsibility to inspect the unit and confirm that all components (device, charger, USB-Cable and instructions) are present by initialling below. In addition, you are responsible for verifying that the Alarm-Button is working by observing the "real-time function-test" performed by the Receptionist and signing below.

I agree *

Summary

My reservation for the Emergency-Device

Accomodation Reservation from To Days

Rental costs and Deposit

Rental costs in €

Deposit in €

Total in €

Pay Now

Personal details and medical information

Personal data

First name

Last name

Address

ZIP code

City

Country of origin

Date of birth

Passport No.

Email

Emergency Contact phone

Medical Information

Allergies

Medications

Additional information

Thank you for your reservation and for your payment!

Your transaction has been completed, and a receipt for your purchase has been emailed to you. You may log into your account at www.paypal.com to view details of this transaction.
You will receive also an Email from iMERGENCIES - Operations-Center with a PDF-Document attached as confirmation.
Upon your arrival at the Hotel Reception your personal Emergency Alarm-Button Unit will be waiting for you.

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YOUR PERSONAL EMERGENCY-DEVICE

Thank you for your reservation and for your payment!