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Liability Waiver & Indemnity Agreement

By Registering for this program, FREE Caring for the Caregiver Mindfulness Program, you hereby:

1. Acknowledge, understand, and agree that Acorn Counselling cannot ensure complete security and confidentiality throughout this virtual program. You agree to comply with the Group Rules designed to mitigate any breaches of confidentiality, and in the case of such a breach, you agree not to hold Acorn Counselling liable.

2. Acknowledge, agree and represent that, considering this program is being facilitated through online and virtual means, Acorn Counselling and all program facilitators are unable to supervise or be responsible for you by any means.

3. You understand, agree, and represent that safety (including that of any child or teen participating in our programming) is your sole responsibility.

4. You, the parent and caregiver of the child and teenage participants, and all participants themselves, will hold harmless and indemnify Acorn Counselling against any and all claims and actions arising out of the participation of the participant in the Free Mental Health Workshop program, including, without limitations, expenses, judgements, fines, settlements and other amounts actually and reasonably incurred in connection with any liability, suit, action, loss, or damage arising or resulting from the participants participation in the Free virtual workshop activities.

Disclaimer:

This workshop is facilitated by a Master of Social Work Candidate and Clinical Intern. This group is not a psychotherapy and these free groups or workshops are not a replacement or substitute for psychotherapy. Should you need additional services, including mental health assessment and treatment, you may access these services in the following places:

• Family Doctor

• Employee Assistance Program (EAP) through employer, if eligible

• Contact Hamilton

• Free Child & Youth Mental Health Services (Previously Walk-in Services through City of Hamilton)

• Private Therapy (You can either contact us to schedule an appointment, or explore Psychology Today for listings of other therapists in the area).

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Credentials / College Registration

Please tell us about your specialty/niche(s). List any certifications, previous experience, or any other information that informs us about your ability to work with kids, teens, and families

Are you available to work (seeing clients) at least 10 hours per week and have 15-20 available client openings?

What is your ideal schedule? What days/times are you available?

Do you have previous private practice experience?

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Why do you want to work in a group practice? Why Acorn Counselling?

What are your long term goals (1-3 years out)? Personally and/or professionally.

What can you bring to Acorn Counselling that sets you apart from other candidates?

Please include your cover letter and resume here *

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Liability Waiver, Parental Supervision, and Indemnity Agreement

By Registering for this program, Free Mental Health Workshops for Kids & Teens, you hereby:

1. Acknowledge, understand, and agree that Acorn Counselling cannot ensure complete security and confidentiality throughout this virtual program. You agree to comply with the Group Rules designed to mitigate any breaches of confidentiality, and in the case of such a breach, you agree not to hold Acorn Counselling liable.

2. Acknowledge, agree and represent that, considering this program is being facilitated through online and virtual means, Acorn Counselling and all program facilitators are unable to supervise your child/teen whatsoever. This includes their use of computers, electronic devices, or the internet.

3. You understand, agree, and represent that the safety of any child or teen participating in our programming is your sole responsibility. You will further ensure that any child under your care that is participating in our virtual programming does so in a safe, careful and responsible manner (including safe and legal use of the internet and their devices).

4. You, the parent and caregiver of the child and teenage participants, and the participants themselves, will hold harmless and indemnify Acorn Counselling against any and all claims and actions arising out of the participation of the participant in the Free Mental Health Workshop program, including, without limitations, expenses, judgements, fines, settlements and other amounts actually and reasonably incurred in connection with any liability, suit, action, loss, or damage arising or resulting from the participants participation in the Free virtual workshop activities.

Disclaimer:

This workshop is facilitated by a highly qualified Child and Youth Counsellor. The CYC is specially trained in and has skills related to child and adolescent development, including therapeutic group facilitation. The CYC is not a psychotherapist and these free workshops are not a replacement or substitute for psychotherapy. Should your child or teen need additional services, including mental health assessment and treatment, you may access these services in the following places:

• Family Doctor

• Employee Assistance Program (EAP) through employer, if eligible

• Contact Hamilton

• Free Child & Youth Mental Health Services (Previously Walk-in Services through City of Hamilton)

• Private Therapy (You can either contact us to schedule an appointment, or explore Psychology Today for listings of other therapists in the area).

We aim to do our best to maintain confidentiality and keep all our participants safe. In order to do that, we need your agreement and understanding of the following:

1. A parent’s name and phone number is required with each registration. We will only contact you if there are safety concerns.

2. We require the location of each group participant at the time of the group.

3. We will only use first names in group, and no information about other participants can be shared with anyone.

4. There will not be any kinds of recordings of sessions, even by our members or facilitators.

5. If there are safety concerns (for self or others), or a suspicion of child abuse, then parents, police, and/or child protection authorities will be notified by the facilitator, as per our legal and ethical obligations.

6. Only registered participants are eligible to attend the virtual workshops so that we can maintain the safety all participants.

7. The cameras/video must remain on so that we can verify age and registration of each participant, and know who is in the space. Adults (especially unrelated to participants) will not be permitted to watch or participate.

8. There is only to be one participant per camera. If sibling groups would like to participate in the same workshop, we ask that each have their own device to ensure minimal distractions for other participants, manageable dynamics for facilitator, and siblings are to use devices in separate rooms to mitigate speaker feedback.

9. Parents and/or caregivers are encouraged to be home or easily available should a participant require additional support. Although we are virtually providing therapeutic programming, we are not responsible for the participant’s safety and encourage adequate adult supervision.

10. These groups are not a substitute for individual or group psychotherapy or treatment. If there are pressing mental health concerns, you are encouraged to explore treatment options on our resource page here.

By registering for group, you acknowledge, understand, agree and represent that you have read the above, and that you are accepting legal responsibility.

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