I understand that Steve Reynolds is not a licensed counselor and that he will be walking alongside us from a pastoral perspective as a teacher, coach, and facilitator. He will work with us in
good faith; we will not hold him responsible for any and all actions we take during or following the taking of the SYMBIS assessment, our reading, discussions, and interactions.
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I have read this carefully, I understand it, and know it contains a release/waiver of liability. Type the date today and your name as your legal signature:
Name:
Address:
City/State/Zip:
Phone:
Email:
I have read this carefully, I understand it, and know it contains a release/waiver of liability. Type the date today and your name as your legal signature:
Copy and paste this form into a document or email. Complete it and email it to: sreynolds@reynoldsper.com. Steve will get back with you.
(c) 2020 * S. Reynolds/Reynolds' P.E.R.
