Skip to content
Home
Support for Women
Why Support for Women
Meet Our Coaching Team
Online Groups
Retreats
Online Community
Webinars
Therapeutic Disclosures
Resources
Blog
Podcasts
Gardens and Grace Coloring Book
About Us
Our Story
Staff
Board
Statement of Faith
Ministry Updates
Join The Team
Shop
Donate
Stones of Hope
Donate Now – Partner with Us
Contact Us
My Account
Home
Support for Women
Why Support for Women
Meet Our Coaching Team
Online Groups
Retreats
Online Community
Webinars
Therapeutic Disclosures
Resources
Blog
Podcasts
Gardens and Grace Coloring Book
About Us
Our Story
Staff
Board
Statement of Faith
Ministry Updates
Join The Team
Shop
Donate
Stones of Hope
Donate Now – Partner with Us
Contact Us
My Account
Welcome, Team!
Welcome to the Redeemed Hope Intensive Healing Retreat. We are so glad you have given your yes to SERVE with us. Please take some time to complete the team member intake form. This form is held confidential and will only be used to serve you and your needs better as a team member. If this form misses a detail that you need to share please feel free to contact Lyschel Burket at support@hoperedefined.org.
Which retreat will you be serving at
Fall 2024
Spring 2025
Fall 2025
Name
(Required)
First
Last
Email
(Required)
Phone
(Required)
Present Occupation
Do you hold any special training or certifications that would be helpful for us to know as you serve on team?
Dietary Needs
(Required)
Gluten Free
Dairy Free
Vegetarian
None
Other
Please explain any specifics to your dietary needs.
Do you have any physical needs that need to be met while at the retreat? (accommodations for sitting, sleeping)
Emergency Contact Name
(Required)
Please provide the name of an emergency contact we may use while you're at the retreat.
First
Last
Emergency Contact Phone
(Required)
Relationship with Emergency Contact
(Required)
Spouse/Partner
Mom
Dad
Friend
Other
Confidentiality Agreement
(Required)
Your communications with Hope Redefined are confidential. The leadership will not release any information without your signed written release. You should also be aware that under some circumstances, your confidentiality may be waived. These circumstances include: threats or acts of harm to yourself or others and abuse of a child in any way. A special clarification for group work is also necessary.
Confidentiality of retreat participants’ communications and information by other group members or team members is not protected by law. However, each participant and team member must be committed to confidentiality to make a safe environment to share openly.
I understand that I am not to disclose to anyone outside the group (especially my spouse, friends, coworkers, pastors, etc.) any information that may identify another team member or participant. This includes, but is not limited to, names, physical description, biographical information, and specifics of content of interactions with other group members. I understand that I am free to disclose to people I choose the fact that I attended the intensive retreat and/or am a part of Hope Redefined.
I have read and agree with the Confidentiality Agreement.
Release for Participation and Volunteering
(Required)
In exchange for participation in the REDEEMED HOPE RETREAT (the “Activity”), organized by, HOPE REDEFINED, located in Knoxville, TN (“Releasee”), I hereby agree as follows:
1. I and anyone claiming on my behalf release and forever discharge Releasee and its affiliates, successors and assigns, officers, employees, representatives, partners, agents and anyone claiming through them (collectively, the “Released Parties”), in their individual and/or corporate capacities from causes of action of any nature and kind, known or unknown, which I may have against Releasee or any Released Parties arising out of or relating to any injury, loss or damage to person and property that may be sustained as a result of participation in the Activity (“Claims”).
2. I understand that participation in the Activity involves inherent risks, including risk of physical or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent paralysis and/or death, and I assume all related risks and voluntarily participate in the Activity.
3. I agree to indemnify Releasee against any and all claims, actions, lawsuits, damages and judgments, including attorney’s fees, arising out of or relating to my participation in the Activity.
4. This Release for Participation in Event or Activity (“Release”) shall not be in any way construed as an admission by the Released Parties that it has acted wrongfully with respect to me or any other person, that it admits liability or responsibility at any time for any purpose, or that I have any rights whatsoever against the Released Parties.
5. This Release shall be binding upon the parties and their respective heirs, administrators, personal representatives, executors, successors and assigns. I have the authority to release the Claims and have not assigned or transferred any Claims to any other party. The provisions of this Release are severable. If any provision is held to be invalid or unenforceable, it shall not affect the validity or enforceability of any other provision. This Release constitutes the entire agreement between the parties and supersedes any prior oral or written agreements or understandings between the parties concerning the subject matter of this Release. This Release may not be altered, amended or modified, except by a written document signed by both parties. The terms of this Release shall be governed by and construed in accordance with the laws of the State/Commonwealth of Tennessee.
I have carefully read and fully understand all the provisions of this Release and am freely, knowingly and voluntarily entering into this Release by checking the agreement nd providing my name and address below.
I agree with this Release for Participation presented by Hope Redefined. My name and date below will be representative of my signature and agreement.
Assumption of the Risk & Waiver of Liability Relating to Coronavirus/COVID-19
(Required)
The coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing. It is recommended by the Tennessee Pledge that the groups follow social distancing guidelines and wear face masks.
Hope Redefined has put in place preventative measures to reduce the spread of COVID-19 during the upcoming Redeemed Hope Weekend Retreat (the Retreat). However, Hope Redefined cannot guarantee that you will not become infected with COVID-19. Further, attending the Retreat could increase your risk of contracting COVID-19. Note: Preventive measures shall include, but not be limited to: 1) hand-sanitizer and disinfectant wipes shall be made readily available; 2) masks and gloves available for those who desire to utilize them; 3) diffusing of antibacterial ionic misters to capture germs 4) particular efforts to provide social distancing during hours of sleep; 5) careful attention to handling of meal prep and service; 6) a brief symptom evaluation will be taken upon arrival and possibly during the Retreat.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by attending the Retreat and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the Retreat may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Redeemed Hope team members and guests.
By signing below I also agree that in the last 21 days I HAVE NOT: 1) tested positive or presumptively positive with the Coronavirus nor have I been identified as a potential carrier of the Coronavirus; 2) experienced any symptoms commonly associated with the Coronavirus; 3) been in any location positively designated as hazardous and/or potentially infected with the Coronavirus by a recognized health or regulatory authority; 4)been in direct contact with or the immediate vicinity of any person I knew and/or now know to be carrying the Coronavirus or who has been identified as a potential carrier of the Coronavirus.
I AGREE to notify Hope Redefined (by email to Executive Director, Lyschel Burket at LyschelBurket@HopeRedefined.org) of any change in status, including diagnosis with Coronavirus and/or quarantine, within thirty (30) days either before or following the Retreat. I also AGREE to consent to having my temperature taken by a Redeemed Hope representative upon arrival and possibly during the Retreat. In becoming symptomatic (fever) I will agree to leave the retreat facility, and seek medical attention immediately.
I ACKNOWLEDGE & ACCEPT that this Declaration shall be governed by the laws of Tennessee. I irrevocably agree that the competent Courts of Tennessee shall have jurisdiction to hear and determine any suit, action or proceeding, and to settle any dispute which may arise out of, under, or in connection with this Declaration and for such purposes hereby irrevocably submit to the jurisdiction of such Courts. Nothing contained herein shall limit the right of Hope Redefined to take proceedings in any other Court of Competent jurisdiction nor shall the taking of proceedings in any other jurisdiction whether concurrently or not one or more jurisdiction preclude the taking of proceedings in any other jurisdiction whether concurrently or not.
I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my attendance at the Retreat. On my behalf, I hereby release, covenant not to sue, discharge, and hold harmless Hope Redefined, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of Hope Redefined, its volunteers, employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any Hope Redefined activity.
Confidentiality of group members’ communications and information by other group members is not protected by law. However, each group member must be committed to confidentiality to make a safe environment to share openly.
I understand that I am not to disclose to anyone outside the group (especially my spouse, friends, coworkers, pastors, etc.) any information that may identify another group member. This includes, but is not limited to, names, physical description, biographical information, and specifics of content of interactions with other group members. I understand that I am free to disclose to people I choose the fact that I attended the intensive retreat and/or am a part of Hope Redefined.
I have read and agree to this COVID waiver.
Is there anything else you'd like to add?
Date of Submission
Month
Day
Year
Δ
Contact Us
Name
(Required)
First
Last
Email
(Required)
Phone
(Required)
I'm interested in:
Online coaching
Online support groups
Online community
Retreat
Therapeutic Disclosure Support
Connecting with ministry
Scholarships
Message
(Required)
Google reCAPTCHA:
We use Google reCAPTCHA to combat spam submissions.
Δ