This consent form serves as a statement of understanding and voluntary consent by you as a participant of Counselling Support or being a part of our outreach for individual sessions offered through Well-being Services by Never Grow Up for TripJack.

Voluntary Participation

I acknowledge that my participation in this counselling session today and here on, is completely voluntary. I understand that the details I share will be confidential and that my counsellor may take notes to remember what was discussed. 

Nature of the Session

​I understand that Well-being Services by Never Grow Up is not a mental health crisis service, and the services provided do not include crisis intervention. The Counsellors affiliated with Well-being Services by Never Grow Up are not authorized to provide any crisis intervention services and any Counsellor providing such form of crisis intervention shall be doing so on their own accord and Never Grow Up and TripJack, or any of their employees, volunteers or assigns shall not be responsible for any cause of action or liability arising due to the same.

Confidentiality

I agree to respect the confidentiality of my counsellor and while Never Grow Up and TripJack will make all efforts to uphold privacy, I understand that the responsibility to respect boundaries also rests with me. Sharing details about my life, is a personal choice. My counsellor commits that he/she/they will keep all discussions as confidential. This confidentiality is subject to certain legal and ethical exceptions, that include:
● Potential harm to self and/or others
● Suspected abuse or neglect of a child, elder, partner and dependent adult
● Legal and/or ethical obligations

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Responsibility

I am attending this session on my own accord, and Never Grow Up, TripJack, and its affiliates or employees are not liable for any emotional distress or impact resulting from my participation in the counselling session. I also take responsibility to consciously act upon the advice offered by my counsellor for follow-up sessions to be fruitful. Also, that I alone will be fully responsible for my choices and actions.

Indemnity

I agree to defend, indemnify and hold harmless Never Grow Up and TripJack, its employees, directors, officers, agents, counsellors and their successors and assigns, its holding, subsidiaries, affiliates, partners from and against any and all claims, liabilities, damages or losses, costs and expenses.

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Communication

I agree to receive follow-up communication from Never Grow Up and TripJack about future sessions, check-ins, or resources with the understanding that I can opt out. By signing below, I acknowledge that I have read and understood the above terms, and I am participating in the counselling session willingly, with a positive approach to bringing change.

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