Agreement for Participation in Non-Professional Christian Support Groups
I understand this Agreement is a legally binding document controlling the terms and conditions of my participation in Door of Hope’s support groups (hereafter referred to as Christian Support Groups). I understand that Door of Hope’s Christian Support Group ministry is non-psychotherapeutic, non-licensed, non-professional Christian support based on the Christian Bible and offered by fellow brothers and sisters in Christ (“Christian Support Groups”). My participation in Door of Hope’s Christian Support Groups is entirely voluntary, and I understand it is not a substitute for psychiatric, psychological or other professional therapeutic services. I accept complete responsibility for my own psychological, emotional and spiritual well-being, and I agree that I am solely responsible to ascertain my need for professional services and to obtain such services as needed. To the extent any Door of Hope staff, intern, or volunteer holds license or certificate in a professional field, including without limitation, psychology, psychiatry, counseling, medicine or law, I understand they are not acting in their professional capacity while participating in this Christian Support Group, and I will not attempt to hold them to any standards required by their licensure or certification. I understand that Door of Hope makes no guarantee that it will “fix” me or free me of unwanted symptoms, and I understand that all EXPRESS AND IMPLIED WARRANTIES ARE SPECIFICALLY DENIED.
Door of Hope values privacy and will endeavor to carefully guard my confidential information. To that end, Door of Hope requires that group participants be at least 18 years old. I understand, however, that there are circumstances such as those listed below which may necessitate Door of Hope sharing my confidential information:
- To consult with colleagues and supervisors, who will also endeavor to keep my private information confidential, to collaborate on how to best serve me, or for supervision and training of Christian counselors
- To prevent me from breaking the law, or harming myself or another person
- To protect me from harm by another
- To comply with a legal duty to report or other legal order, or
- To seek legal or other professional advice
- If you are currently seeing a therapist, we will need a signed release so that we may speak to him/her as needed
To cover basic costs of its Christian Support Group program, Door of Hope charges a $95 registration fee per 9-week session.
By registering for this appointment, I acknowledge that I have thoroughly read and understood it, and unreservedly accept its terms. I also verify that I am at least 18 years old. This Agreement will remain in effect as long as I participate in the Door of Hope Christian Support Groups, and the waiver and release of liability terms shall survive the termination of this Agreement.
