I declare that I am 15 years or older (minimum age for safeTALK training is 15 years with a preference to be accompanied by parent or carer).
I have voluntarily elected to enrol in the suicide prevention training course delivered by Grapevine Group Association Inc. under the title of safeTALK.
I acknowledge that the safeTALK training program is delivered by but not written by Grapevine Group Association Inc. who accept no responsibility for the content of the training course and I agree that I hereby indemnify and hold harmless Grapevine Group Association Inc. in respect of any action, claim or demand that may be made by me or on my behalf for any loss, damage or injury as a consequence or otherwise in relation to the training delivered by Grapevine Group Association Inc.
If the trainers delivering the course determine that I should discontinue the training and/or that I should leave the venue for the sake of my own safety, welfare or comfort or that of other participants I shall comply with all such directions.
I agree to participate in a survey to assist with collection of training data and I consent to my answers being used for that purpose or such other purpose as determined by Grapevine Group Association Inc.
I hereby grant to Grapevine Group Association Inc an unconditional and irrevocable consent and licence to use for no reward of other consideration my name and image or likeness (including photograph, portrait, video image or any other image in any form of media), voice, title of office, professional credentials or affiliations in advertising or marketing material in print, digital or any other form of media (including social media or online platform) whether now existing or hereafter created for the purposes of any form of advertising, marketing, publicity or public notice or announcement approved by the Grapevine Group Association Inc in conjunction with any text, sound or images (including the likeness of others) and to incorporate any such uses together at the absolute discretion of Grapevine Group Association Inc.