As a client of the Futures Foundation, I, * consent to the following on behalf of :
- Receive services/support from the Futures Foundation
- Fully defend, indemnify, and hold harmless the Futures Foundation from any and all claims, lawsuits, demands, causes of action, liability, loss, damage and/or injury, of any kind whatsoever ( including without limitation all claims for monetary loss, property damage, equitable relief, personal injury and/or wrongful death), whether brought by an individual or other entity, or imposed by a court of law or by administrative action of any federal, state, or local governmental body or agency, arising out of, in any way whatsoever, any acts, omissions, negligence, or willful misconduct on the part of the Futures Foundation or by its officers, owners, personnel, employees, agents, contractors, invitees, or volunteers. This indemnification applies to and includes, without limitation, the payment of all penalties, fines, judgments, awards, decrees, attorneys’ fees, and related costs or expenses, and any reimbursements to The Futures Foundation for all legal fees, expenses, and costs incurred by it.
- The release of my personal information such as name, phone, county, birth date, etc. and other related case information to the appropriate partners for any/all interagency referrals, services, or other providers as needed to provide comprehensive support as deemed necessary by the Futures Foundation and its staff.
- Was read/explained/provided the Program Support Disclosure & Privacy Guide as well as the Notice of Conflict of Interest Policy.