When Love Hurts Registration
Date: July 14, 2021
Time: 9:00 am to 4:30 pm
Location: Virtual
Contact: Darryl-Jean Peeman, YES Coordinator at 778-392-8133 or YES.Coordinator@syilx.org 

Join us for a one-day workshop to learn more about the When Love Hurts model and practice to support those who are experiencing abuse.

We will explore how to use four essential exercises to help individuals name, understand and heal from their experiences of abuse.

Open to Syilx Nation Members and Community Members.

Sign in to Google to save your progress. Learn more
Email *
Name (First & Last) *
Phone Number *
Email (preferred method for joining virtual events)
Community *
Age Group *
Emergency Information
We realize that this event is virtual, and although it is virtual, we want to ensure that all participants are safe. For your safety & in the case of potential incidents, the Okanagan Nation Alliance would like to have an emergency contact and your address available. This is being requested in the case that you may be having a medical emergency or require medical assistance during this events. The information you provide will be kept confidential and will only be used in the case of a true medical emergency.
Emergency Contact (Name & Number)
Physical Address During Event (will only be used in case of medical emergency)
Permission Information
I hereby release, discharge and covenant not to sue the Okanagan Nation Alliance, their respective administrators, directors, agents, officers, members, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessees of premises on which the Activity takes place, (each considered one of the "RELEASEES" herein) from all liability, claims, demands, losses, or damages on my account caused or alleged to be caused in whole or in part by the negligence of the “release” or otherwise, including negligent rescue operations; and I further agree that if, despite this release and waiver of liability, assumption of risk and indemnity agreement I, or anyone on my behalf, makes a claim against any of the Releases, I will indemnify, save and hold harmless each of the RELEASEES from any litigation expenses, attorney fees, loss, liability, damage, or cost which any may incur as the result of such claim.  Nothing herein shall be construed as a waiver of the Sovereign Immunity of the Okanagan Nation Alliance.
Please type name & date to sign *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy