INFORMED CONSENT
Welcome to Lion's Heart Family Grief Day Camp!
Please read through the information below and feel free to ask your questions about our activities and/or anything about us. Once you are ready to participate, please sign this informed consent form below so we will have on our records that you have read the information and that you have been properly informed about the day camp experience.
EXPECTATIONS
This is not a professional therapy group.
Services are free of charge, and lunch will be provided.
Children ages 5-18 as well as their parents/guardians are invited to participate.
There will be no childcare for younger children available, so please plan ahead.
Please don't come if you're feeling sick or unwell. We want to be ready to play!
Parents/Guardians must stay on-site throughout the program (please, no drop offs of your children).
Family Grief Day Camp is a unique kind of therapeutic group experience, where a group of people who are experiencing a loss gets together to share their difficulties, which as a result give and at the same time, receive help from each other.
We make sure to maintain a safe environment that is conducive both for sharing and accepting each other where each can grow and trust one another, and where each and everyone will feel respected and valued.
Day Camp will be broken up into 3 general age groups: 1. Elementary school-aged children, 2. Middle-School and High-School, and 3. Parents/Guardians. There will be big group games and opening/closing activities. Participants will interact with their peers with specially-trained leaders.
Lion's Heart is staffed by competent grief professionals and their trained volunteers. Day Camp is a fun, therapeutic group, where children and adults will have the opportunity to talk about their experience with loss. Due to the nature of talking about grief, one may have a strong emotional reaction to the activities in camp. Should a participant feel they cannot continue with the activities, they may receive additional support from trained professionals on-site, or they are free to exit at any time.
CONFIDENTIALITY
We respect each and everyone's right to privacy and confidentiality and we shall make sure to maintain it that way. However, please understand that this is not absolute and is limited to provide for by law. Certain limitations are as follows:
Threatening one's self or another that may result in physical harm;
An act of physical or emotional abuse against a child or any person;
Sexual abuse against a child where the child is living with the abuser;
Whenever we are summoned by court order to disclose information against a participant.
Your prior written consent to release records.
CONDUCT AND RELATIONSHIP
It is necessary that the following is required to be complied with by its members:
Discussions made within the group session are not allowed to be discussed outside with anyone and should maintain the practice of confidentiality in order to build trust with fellow members;
Members should maintain positivity and not induce disrespect among others;
Members should not be drunk, nor they are allowed to take alcohol or take drugs before or after day camp;
Maintain conduct that brings respect to fellow members' thoughts, emotions, or behavior;
Refrain from having a relationship with a fellow member other than therapeutic while engaged in the session.
THE LEADERS
The group leaders and volunteers should maintain a professional relationship with the participants at all times, and no more than that. Any relationship with a participant may result in a "dual relationship" and may affect the goals of the session.
CONSENT
I agree to adhere to the norms and expectations for day camp as indicated above. I acknowledge that I have had the opportunity to ask questions and such questions were answered clearly and to my satisfaction.