This document is being provided in connection with the services, activities, and programs (collectively, “Services”) offered by Bethany Christian Services of Michigan, a Michigan nonprofit corporation (“Bethany”) related to the Grand Rapids Center for Community Transformation (“GRCCT”). If you have any questions about the following, please ask a staff member to explain. In this document, the term “Services” will refer to the services, activities and programs offered by Bethany at or in connection with the GRCCT.
INDIVIDUALIZED SERVICE PLAN: You have the right to be involved with developing an individual service/activity plan that identifies what Services you will engage in and how those Services address your needs and goals. The plan will be reviewed periodically with you and/or your parent/guardian.
VOLUNTARY PARTICIPATION AND WITHDRAWAL OF SERVICES: You have the right to ask questions and to be informed regarding any Services in which you are asked to participate. You have the right to decline Services and terminate your involvement at any time without fee or penalty.
GRIEVANCES: If you have a concern about the Services or decisions made about you—you (or a parent/ guardian if allowed by law) may discuss the matter informally with the program manager or director of programming. You may also submit your concern in writing. If not resolved, you may present the grievance to the next level personnel.
Consent to Participate and Release of Claims: I consent to participate in the Services provided by Bethany. I am aware that there are potential hazards and risks involved. I am willingly consenting to participate in all aspects of the Services (including, but not limited to, field trips, transportation and the paid work experience). I hereby release and discharge Bethany and the other Released Parties (as such term is defined below) from and against any and all claims, damages and liabilities arising out of or related to the Services or the GRCCT, including without limitation any personal injury or death. This release applies regardless of any negligence or other wrongful conduct of Bethany or any of the other Released Parties. I assume all risks associated with the Services or the GRCCT. I make this release knowingly and voluntarily. I agree that the above release is intended to be as broad and inclusive as permitted by the laws of the State of Michigan and that, if any portion of this release is held invalid, the remaining part of this release will continue in full force and effect. I irrevocably and unconditionally waive my rights to a trial by jury in any action that arises out of or relates to this release or the Services by Bethany or any other Released Parties. As used above, the term “Released Parties” refers to Bethany, its affiliates (including Bethany Christian Services, a Michigan corporation, and all other parent companies, subsidiaries and other related companies) and all of its and their respective officers, directors, employees, agents, representatives and volunteers.