Participant Agreement & Release Form

Please read the following terms and conditions below before submitting the form.

All C-HOPE volunteers are expected to maintain confidentiality while volunteering for/with C-HOPE. This includes treating all participant information as personal and confidential, regardless of source and refraining from discussing participant progress, behavior, and other confidential information with anyone outside the program. I understand that volunteering with C-HOPE is a privilege and not a right. C-HOPE reserves the right to deny or remove any volunteer violating confidentiality or program policy. By signing this agreement, I am stating that I understand and will adhere to the expectations stated above.

By signing below, I give C-HOPE permission to use photographs and audio and/or video recordings of me for marketing and/or fundraising purposes. This includes promotional videos, websites, brochures, newsletters, and similar marketing materials/media. C-HOPE respects the privacy of its participants and does not knowingly allow unauthorized visitors to take images of participants.

By signing below, I assume no ownership of any product I produce or assist with producing, This includes sales of projects that showcase the talent of C-HOPE participants.

I hereby release and hold harmless C-HOPE, Inc., its officers, directors, employees, agents, representatives, volunteers, heirs, executors, and assigns from all liability for personal injury, including death, as well as all property damage or loss arising out of my/my child’s participation in this program and any travel/transportation-related to this program, whether paid for by myself or by C-HOPE. I understand that this release and indemnification releases liability for the conduct of C-HOPE and its officers, directors, employees, agents, representatives, volunteers, heirs, executors, and assigns. Information on program participants’ progress may be collected and used in aggregate form in non-identifying ways to measure and demonstrate the efficacy of C-HOPE programs.

VERIFICATION OF UNDERSTANDING(Required)
By initialing the boxes below, I confirm I have read and understand each of the sections above.
MEDICAL EMERGENCY CONSENT
I, (or I/We, being the parent/guardian of ) give consent for emergency medical and/or surgical treatment in a licensed medical facility and by a licensed physician should [I require it]/[my child’s condition require it in my absence. I/We understand that in such a case, reasonable attempts would first be made to contact us, with time and conditions permitting]. As long as the medical and/or surgical treatment considered necessary in the situation is in accordance with generally accepted standards of medical practice for the particular type of injury or illness involved, no specific prohibitions regarding treatment are imposed unless stated below:
PARTICIPANT CONSENT(Required)
The undersigned consents to the above and agrees to participate in any and all activities of C-HOPE programs.
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Parent/guardian signature (volunteers under age 18)
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Consent(Required)
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Name(Required)
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