• Parent / Guardian

  • Child / Self

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  • Person Centered Plan

    The purpose of this Plan is to create lasting connections between potential workers and your child. Please include any information that will help workers get to know your child. We will likely share this section with potential workers.
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  • Waiver and Release of Liability

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  • I/We, the undersigned, are the parent(s) or legal guardian(s) of (the "individual").

  • Release of Liability, Waiver of Claims and Indemnity Agreement

    Out Of The Box Solutions, LLC, is a limited liability company under the laws of the state of Oregon.


    In consideration of Out Of The Box Solutions, LLC referral of a Personal Support Worker for the individual, the undersigned acknowledges, understands and agrees:

    1. To waive any and all claims that I/We have or may in the future have against Out Of The Box Solutions, LLC AND TO  Out Of The Box Solutions, LLC, its officers, trustees, agents, and employees, from any and all liability for any loss, damage, expense, or injury, including death, due to any cause whatsoever, including negligence, breach of contract, or breach of any statutory or other duty of care on the part of Out Of The Box Solutions, LLC;

    2. To hold harmless and indemnify Out Of The Box Solutions, LLC from any and all liability for any property damage, loss or personal injury to any third party;

    3. This Agreement shall be effective and binding upon my heirs, next of kin, executors, administrators, assigns, and representatives;

    4. This Agreement and any rights, duties, and obligations as between the parties to this Agreement shall be governed by and interpreted solely in accordance with the laws of the state of Oregon and no other jurisdiction; and

    5. Any litigation involving the parties to this Agreement shall be brought solely within the state of Oregon

    and shall be within the exclusive jurisdiction of the Courts of the state of Oregon.

    I have read and understood this agreement, and am aware that by signing this agreement I am waiving certain legal rights which I or my heirs, next of kin, executors, administrators and assigns may have against Out Of The Box Solutions, LLC.

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