OurHistory Retreat Waiver & Disclaimer

OurHistory Retreat is hosted by AdopteeBridge staff and volunteers who will assist retreat participants within the context of the retreat. Participation by attendees in OurHistory Retreat or any associated function(s) is not intended as a substitute for professional counseling and/or medical treatment.

By signing this agreement form, I freely and voluntarily agree and understand the following statements to be true and I hereby agree to bind myself to such statements in consideration for the opportunity to participate as an attendee of the upcoming OurHistory Retreat:

• AdopteeBridge staff are not licensed professional counselors and are not giving medical or mental health advice, making diagnoses, or providing licensed professional counseling.

• I will not hold AdopteeBridge staff, volunteers, Board Members, or other persons or entities directly associated with AdopteeBridge responsible for my actions or the actions of others made in response to any facilitation, teaching, or advice, received/obtained during the OurHistory Retreat

• Any information I give to AdopteeBridge staff will remain confidential. However, I also understand exceptions to such confidentiality include:

  • Any situation in which I communicate I am considering physically harming myself or another person or any situation in which I communicate another person is continuing to or has expressed his/her intent to physically harm me.

Any formal grievance brought against AdopteeBridge, the staff, volunteers, Board Members, and/or persons/entities directly associated with them are to be decided under Minnesota law and, if litigation ensues, in Minnesota courts of law —the state and federal courts in which are deemed a proper venue by the undersigned for any such action—wherein such courts, based on this agreement, shall have personal jurisdiction over the undersigned.

I am participating in an activity sponsored by AdopteeBridge, and hereby release, waive, indemnify, defend, and hold harmless AdopteeBridge  staff and volunteers, from and against any and all claims, for bodily injury demands or causes of action of any type whatsoever, including property damage or personal injury, damages, losses and expenses, including but not limited to attorneys’ fees, arising out of or in any way related to participation in this trip with which I/we will be involved.

In the event of an emergency, I authorize AdopteeBridge and volunteers to obtain medical and/or surgical treatment on my behalf at no cost to the organization or volunteer. I hereby release, in the event of any injury or illness, and if deemed necessary by AdopteeBridge staff to make whatever emergency measures (i.e., first aid, disaster evacuations) that are judged necessary for my care and protection while participating in an event sponsored by AdopteeBridge. In the case of a medical emergency I understand I will be transported to an appropriate medical facility by the local emergency unit for treatment if the local emergency resource (police, rescue squad, or fire department) deems it necessary.  

I am aware there are possible risks and dangers associated with my participation. I assume full responsibility for any injuries or damages I may sustain as a result of my participation, including travel to or from the trip destination. In addition, I assume liability for and agree to indemnify and to hold the AdopteeBridge and its employees and volunteers harmless for all claims or damages caused, in whole or in part, by me and any negligent, intentional, or other act or omission on my part.

If any part of this agreement is deemed void by a court of law, the other portions of the agreement will remain in full force and effect.