The following is required for your participation in the Awaken Training. Please complete the Personal Assessment without delay, as it may require additional information or signatures.

If you haven't already, you will be receiving a call from a GAP team member to set-up a one-hour time for your pre-training Support Call. The purpose of that call is to go over the same info in this form, as well as to support you in getting clear on your purpose and vision for your training time.

This part of the assessment is not intended to be used for purposes of screening. We do not and cannot screen our participants. Only you can decide what is right for you and the appropriateness of your participation. The information requested in this form and presented in the Course Outline is provided to assist you in doing that.

Please answer all of the following questions completely. Your answers will be kept confidential. The information requested here is to enable us to better support you in the Training. However, it is not possible for us to predict any participant’s experience. If during the Training, you find yourself feeling uncomfortable to a degree that you think is excessive, we request that you report this immediately to the trainer or a team member.

If you have any question about whether or not you should participate at this time, please consult a professional. In some cases, we will require that you do so.

You answered “yes” to question indicating that you are currently seeing a mental health professional or have been in the last year. We require that you discuss with your current or former therapist the advisability of your taking The Awaken Training at this time. You must sign the Therapy Personal Release below, verifying that you will have a conversation prior to the training.

We urge you to fully express to your therapist any concerns you may have, and listen closely to any concerns your therapist may have for you. We strongly recommend that you follow your therapist’s advice as to whether or not this is an appropriate time for you to take the Training. If your therapist requires more information, they are welcome to review this form and/or contact the GAP Awaken Director of Communications, Marla Neighbour, at 909.730.3888.

THERAPY PERSONAL RELEASE

I will talk with my therapist, and asked his/her opinion about my participation in the Training. My choice to participate in the Training at this time is made with the benefit of my therapist’s advice.

I am aware that by typing my first and last name below and submitting this form, it is representative of my signature.

This release must be completed and signed if you have:

1. Ever been hospitalized for psychiatric care or for a mental health crisis OR
   
   
2. Taken or been prescribed any anti-psycitic, antidepressant or anti-anxiety medications within the past 5 years.

 Please note the following:

• If you have been hospitalized or taken or been prescribed any anti-psycitic, antidepressant, or anti-anxiety medications within the past 12 months, the prescribing physician's signature is required.
  
  
• If you have been hospitalized or taken or been prescribed any anti-psycitic, antidepressant, or anti-anxiety medications within the past 5 years, but more than 12 months a ago, any physician's signature is sufficient.

Your participation is at your own risk, but you must have the appropriate signatures as indicated in this packet in order to participate in the Awaken Training.

INSTRUCTIONS:
Go to the www.gapcommunity.com/awakenforms or click on the direct link below that will direct you to the website page necessary to pass on to your physician for his/her electronic signature.

ONLINE PHYSICIAN'S RELEASE FORM LINK:

CLICK HERE

EXCLUSION POLICY
Awaken Trainers reserve the right to exclude people from participating in The Awaken Training for whom they believe the Training may be inappropriate.

Due to the recent, dramatic increases in the cost of liability insurance, The Awaken Training is unable to secure this type of coverage. One of the three required Awaken forms prior to attending the training is called the Hold Harmless. In this form, you will be asked to sign a standard release agreeing to assume full responsibility for your participation in the Training, agreeing not to sue GAP Community or our Sponsor, and agreeing to settle by arbitration any dispute that may arise.

If you choose not to sign the form, you may participate in the Training for a payment of an additional $300.00.

If you have any questions, you can contact the GAP Director of Communications at (909) 730-3888.

SECTION I: CONSENT TO PARTICIPATE

1. I acknowledge that I am fully and satisfactorily informed about the Training offered by GYTS/GAP COMMUNITY and Sponsor and that I am freely and willingly participating in the training.
   
   
2. I understand that the training and all reference to the training includes not only the four days but also future related activities in which I may or may not choose to participate.
   
   
3. I understand the TRAINING is an experiential, philosophical, Christian education program that may or may not assist in personal growth. It is neither psychotherapy, nor medical therapy nor a substitute for either of these. GYTS/GAP COMMUNITY trainers are not licensed psychiatrists or psychologists.
   
   
4. I understand that the TRAINING may involve physical contact such as hugging and if I do not consent to this I may object or tell the trainer before or at the time the contact occurs. I further understand that several of the processes in the TRAINING involve sharing which may evoke deep emotions, possible emotional stress, anxiety, tears or physical discomfort or exhaustion.
   
   
5. I do not have any doubts about my mental health and/or emotional stability in regards to handling the rigors of the TRAINING. I have resolved any such doubts I may have had about the TRAINING by consulting others who are knowledgeable including but not limited to a physician, psychiatrist, psycho-therapist or psychologist. Such person(s) have no objections to my participation in the TRAINING.
   
   
6. I understand that GYTS/GAP COMMUNITY, Sponsor, their employees, staff and team members (“GYTS/GAP COMMUNITY and Sponsor Team”) are here to assist me and are responsible only for presenting the TRAINING in an orderly manner. The GYTS/GAP COMMUNITY and Sponsor Team are not my fiduciaries and I do not expect the TRAINING to be administered with the standard of care expected of trained mental health professionals. If I feel mental or physical discomfort or adverse effects during the TRAINING, I will inform a GYTS/GAP COMMUNITY and Sponsor Team member immediately.
   
   
7. I understand that I am free to leave the TRAINING at any time or any reason. If during the TRAINING I feel the need for assistance from anyone, either professional or otherwise, I will contact and obtain such assistance.

SECTION II - INSURANCE DISCLAIMER

1. I understand that GYTS/GAP COMMUNITY and Sponsor do not provide any insurance (neither medical, liability, professional nor incident) for my participation in the TRAINING. Thus, if I want insurance of any kind, it is my full responsibility to obtain such insurance.

SECTION III – RELEASE OF LIABILITY and WAIVER OF RIGHT TO SUE

1. Assumption Of Risk: I am fully aware that participating in the TRAINING may contain risks of physical or psychological injury. I know and fully understand the scope, nature and extent of the risks involved in the TRAINING and activities contemplated by this Agreement. I voluntarily and freely incur and assume any and all such risks and dangers.
   
   
2. I hereby fully and forever discharge and release GYTS/GAP COMMUNITY and Sponsor from any and all liability, claims, demands, actions and causes of action whatsoever arising out of any damages, both in law and in equity, in any way resulting from personal, physical, psychological or emotional injuries, distress or death arising from or in any way related to the TRAINING. This release from liability includes loss, damage or injury resulting from the negligence of GYTS/GAP COMMUNITY and Sponsor from any other cause or causes.
   
   
3. I agree not to institute, initiate or assist the prosecution of any suit, claim or action at law or equity or otherwise against GYTS/GAP COMMUNITY and Sponsor for damages which I or my heirs, executors, administrators, or assigns hereafter may have arising from or in any way related to the TRAINING. This release from liability includes loss, damage, or injury resulting from the negligence or GYTS/GAP COMMUNITY and Sponsor from any other cause or causes.
   
   
4. Indemnity: I agree to indemnify and hold harmless GYTS/GAP COMMUNITY and Sponsor from any and all losses, claims, actions or proceedings of any kind which may be initiated by me and/or any other person or organization on my behalf against GYTS/GAP COMMUNITY and Sponsor. This indemnification includes reimbursement of all legal costs and reasonable attorney’s fees incurred by GYTS/GAP COMMUNITY and Sponsor to defend any such actions.
   
   
5. Waiver of Punitive Damages: I understand and agree that I am waiving and forever abandoning any claims for punitive, or exemplary, incidental or consequential damages, against GYTS/GAP COMMUNITY and Sponsor. I voluntarily choose to give up this right.

SECTION IV: ARBITRATION

1. Arbitration: I agree that any controversy claim again GYTS/GAP COMMUNITY and Sponsor not released herein, arising out of or relating to my participation in the TRAINING, shall be settled first by mediation between the parties then by arbitration in accordance with the rules of the American Arbitration Association, and not by lawsuit or resort to court process. I fully understand I am giving up my right to sue GYTS/GAP COMMUNITY and Sponsor in a court of law or equity. This shall apply to all claims, including allegations that there have been wrongful acts or omissions by GYTS/GAP COMMUNITY and Sponsor either intentionally or otherwise. The arbitrator’s decisions may be entered in any court having competent jurisdiction. By signing this I am agreeing that any issue or claim arising out of my own participation in the TRAINING shall be decided by neutral arbitration. I am giving up my right to trial by a jury or judge.

SECTION V: MISCELLANEOUS

1. Governing Law: I understand that this Agreement shall be construed and governed by the laws of the State of California, and that it cannot be modified unless in writing and signed by both parties.
   
   
2. Entire Agreement: I understand that this Agreement contains ALL the provisions, promises and agreements between the parties with regard to the release of GYTS/GAP COMMUNITY and Sponsor. I acknowledge that there are no oral or written promises or agreements outside of this agreement regarding the release of GYTS/GAP COMMUNITY and Sponsor.
   
   
3. Contract: I hereby expressly recognize that this Agreement is a contract I have released any and all claims against GYTS/GAP COMMUNITY and Sponsor.

CONSENT

I have carefully read this agreement and understand its contents. I certify that I am 18 years of age or older and I sign this agreement of my own free will.

For and in consideration of the mutual promises and agreements set forth above, and for my voluntary participation in the GAP Community training, by signing my name below, I agree to this entire agreement and each of its individual sections.

By clicking submit, I hereby acknowledge and attest that I have thoroughly and carefully read the information contained herein, that I understand it, that I have answered all the questions fully and truthfully, and that I take full responsibility for my participation in The Awaken Training.