Exit Self-Care & Restoration Workshop SAFE SPACES Question Title * Name Question Title * Email address Question Title * Are you a teacher, administrator, support staff or other person that supports youth/young people? Yes No Question Title * What school(s) AND/OR organizations are you affiliated with? Question Title * Please describe what you hope to gain and/or experience during the self-care & restoration workshop? Question Title * Liability Waiver Please review the attached liability waiver. PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only. Choose File Choose File No file chosen Remove File Please review the attached liability waiver. Question Title * I, THE UNDERSIGNED PARTICIPANT, AFFIRM THAT I AM OF THE AGE OF 18 YEARS OR OLDER, AND THAT I AGREE TO THE TERMS OF THE LIABILITY WAIVER. I CERTIFY THAT I HAVE READ THE AGREEMENT, THAT I FULLY UNDERSTAND ITS CONTENT AND THAT THIS RELEASE CANNOT BE MODIFIED ORALLY. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND THAT I AM SIGNING IT OF MY OWN FREE WILL. Yes No Question Title * Our organizations hope to continue to find ways to support you. Please share your thoughts on ways we can ensure that you feel cared for and supported as you care for and support our young people? Done
