Liability Waiver for Journey Through Loss Bereavment Support Group

This waiver of liability includes any risk of attending in-person sessions, engaging in online sessions, or attending any events, or other bereavement support group services(“Services”) provided by Journey Through Loss (“JTL”). By agreeing to this waiver:

• You understand that JTL Services are not offered as a substitute for medical care and are not intended to diagnose or cure any mental health or medical conditions. Also, you understand that our facilitators are not acting as medical or mental health professionals.
• You understand and agree that you are fully responsible for your own well-being during your access to the Services, and you are responsible for making your own choices and decisions.
• You understand that the information you provide to us will be shared with other JTL facilitators. This information cannot be released without your informed and written consent, except:

1. in circumstances where we have a duty to report child abuse and neglect,
2. when there is a threat of harm to yourself or others, or
3. when we are served with a court order.

• You understand that all comments and feedback offered by our facilitators are for the sole purpose of assisting you in achieving your goals. You will be able to give informed consent, and hereby give such consent to the facilitator(s) to assist you in achieving such goals.
• You understand that the use of technology is not always secure and accept the risks to confidentiality in the use of email, text, phone, online services and any other technology.
• You hereby release, waive, acquit and forever discharge JTL, including, but not limited to: JTL or its directors, volunteers, students, and their respective successors and representatives, from every claim, suit action, demand or right to compensation for damages claimed or that you may have arising out of your own acts or omissions or acts and omissions of JTL or its directors, volunteers, students, and their respective successors and representatives, as a result of any advice given otherwise resulting from the relationship contemplated by this agreement.

By clicking “Submit” below, I acknowledge I have read and understand the provisions in this form and consent to same.