If you do not want us to invite anyone else, please write NA.
Program Participation Consent
I hereby consent for myself to participate in the Family First for First Responders Program at Kids' Turn San Diego. The purpose of the Program is to provide creative strategies to overcome the challenges of raising children in a First Responder Home. This program offers support to First Responders and their Spouses in a safe and confidential space and focuses on improving family relationships and navigating the First Responder Family Culture. This program is offered in three formats: Group Class with other families, Couple Sessions and Individual Sessions. By providing contact information for your spouse/partner, you authorize Kids' Turn San Diego staff to invite them to the program. I agree and give my consent to participate in the Family First program. I understand that, within the bounds set by law, information, communications, observations and opinions derived from this program is considered confidential and that Kids' Turn San Diego Staff are mandated reporters of child abuse, elder abuse and child exposure to domestic violence. I understand that after successful completion of the program, I will receive a certificate of attendance. I understand this is NOT a court approved co-parenting program. I also understand that the program may be described in written publications, but that no information will be provided that could identify any individual participants in the program without their written consent. I agree that neither myself nor anyone representing me shall call on any staff persons involved in this program during or after my participation in the Kids' Turn San Diego Family First for First Responder Families program to provide either written or oral testimony at a deposition or in court on any issue related to my family. Neither I nor my representatives will subpoena any records from Kids' Turn San Diego for any purpose. I waive any right that I may have to call such person or subpoena such records in this or any action that is or may be filed. Further, all documents produced in the program become the property of Kids’ Turn San Diego. I give my consent for Kids’ Turn San Diego to use artwork, images or quotations made by me in brochures, literature or other public relations activities, but understand that I will not be identified by name. I understand that the facility used for the program is in no way responsible or liable for any action associated with the Family First for First Responder Families program. I understand that Kids’ Turn San Diego has grant funding for this program and there is no cost to attend the first Class/Session. I have signed below indicating that I have read, understand and agree to the above information.