Inquiry Form for Youth

Help Us Get To Know You

Hold Harmless Statement

On behalf of myself and on behalf of my dependents, I fully and forever release, discharge and hold harmless Lift for Life and its directors, officers, employees, advisors, affiliates, fundraisers, donors, and sponsors of and from any and all claims, demands, actions, cause of action, suits, controversies and liabilities of every kind and nature accruing to me or my dependents or any other person arising directly or indirectly from or on account of, or otherwise related to, the activities and assistance of Lift for Life.

I have read and accept all terms of the Hold Harmless Statement

Non-discrimination Policy

Lift for Life does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or operations. These activities include, but are not limited to, hiring and firing of staff, selection of volunteers and vendors, and provision of services. We are committed to providing an inclusive and welcoming environment for all members of our staff, clients, volunteers, subcontractors, vendors, and clients.

I have read the Non-discrimination Policy

Electronic Services Informed Consent Statement

Lift for Life utilizes interactive technologies that incorporate network and software security protocols to protect the privacy and confidentiality of client information transmitted via our Client Portal. These protocols include measures to safeguard the data and to aid in protecting against intentional or unintentional corruption.

Services may be provided through interactive technologies including but not limited to video, phone, text, apps, email, or other electronic means. Despite the benefits of the aforementioned security measures, there are limitations associated with the use of electronic service delivery. Applicants will need access to, and familiarity with, the appropriate technology in order to participate in the Lift for Life program and services.

I have read and accept the terms of the Informed Consent Statement