Release of Condentiality and Liability Waiver

Alpine Connection Counseling LLC

Event dates: November 7-9 Event name: Colorado School Counselor Association Annual Conference Event location: Vail Colorado I give my permission for _____________________ to attend the CSCA with Alpine Connection Counseling LLC on November 7-9 and permission to release condential information regarding my child for the purpose of educating others for this event. By singing this Waiver, I assume any risk, and take full responsibility and waive any claims of personal injury, death or damage to personal property associated with Alpine Connection Counseling LLC activities and events organized by Alpine Connection Counseling LLC. I understand and conrm that by signing this WAIVER AND RELEASE I have given up considerable future legal rights. I have signed this Agreement freely, voluntarily, under no duress. My signature is proof of my intention to execute a complete and unconditional WAIVER AND RELEASE of all liability to the full extent of the law for the benet of Alpine Connection Counseling LLC, its employees, members, managers, and agents. I am 18 year of age or older and mentally competent to enter into this waiver and have legal guardianship to consent to this release from liability.

Parent signature: ______________________________

Date: ___________________

Participant Agreement
(for your child to read and sign) Attending this event is a tremendous privilege. Misconduct during this event will result in denial of any future opportunities to participate in these venues. Your responsibilities include being on time, prepared, being where you say you are (when not on stage) and to represent Alpine Connection Counseling LLC with integrity. There will be a reasonable agreed upon time each evening that will be a curfew you must agree to and not leave your room after the set curfew (unless there is an emergency) for safety and liability reasons. Any illegal behavior including the use of illegal substances or destruction of property will not be tolerated and will result in immediate disqualication from this event and future events. Because you will have both tremendous freedom and responsibility, I am trusting you to make good decisions and represent Alpine Connection Counseling LLC well. By singing this document you agreeing to these expectations. Bottom line if you have a question about something is this: If your parents wouldnt approve....then I dont approve.

Participants signature: __________________________ Date: _____________________