Finance Coaching Participant Application

Thank you for filling out this confidential application. Keep in mind that there are no wrong answers. Your answers are very important, as we want you to have a great experience during your coaching meetings.

Personal Information

Current Situation

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Coaching Request

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Financial Coaching Disclaimer and Waiver

I (referred herein as the "Participant(s)"), hereby acknowledge and confirm the following:

1. Participant(s) has requested Providence Church (referred herein as the
“Church”) to provide financial coaching services (referred herein as the
“Services”) to him and/or her solely on an advisory basis.  The Services are being
provided with the understanding that the Church is not engaged in rendering
legal, tax, financial, counseling, or other professional services or advice.

2. Participant(s) is utilizing any or every part of the Services entirely at
Participant(s)’ own risk.  Services are being provided “as is” without warranty of
any kind, either express or implied, including without limitation any warranty for
information services, counseling, or products and serves provided through or in
connection with the Services.  The Services are requested at the Participant(s)’
own choice and with inherent singular responsibility.  The Church shall not be
responsible for any loss or damage caused, or alleged to have been caused,
directly or indirectly, by the information or ideas contained, suggested, or
referenced in the Services.  Participant(s)’ use of the Services indicates
Participant(s)’ understanding that the Participant(s)’ is/are able to make his or
her own decisions about financial matters, and the Church is not responsible for
any financial decisions or funding decisions made by Participant(s)’, or which
Participant(s)’ fail to make.

3. The Church’s Services are being provided free of charge.

4. In general, all communications between Participant(s) and Coach are
confidential. No information about Participant(s) will be released outside the
Church without Participant(s)’ permission.  The EXCEPTIONS to confidentiality
include, but are not limited to, the following: (1) the coach determines
Participant(s) is a threat to himself or herself, or another person; (2) there is
suspected abuse or neglect of a child, an elderly or disabled person; (3)
Participant(s) is threatening to commit a crime; (4) there is a medical
emergency; or (5) through a court order to disclose Participant(s)’ records.  In
the event of such a situation, Coach will make reasonable efforts to discuss it
with Participant(s) before taking any action.

5. Participant(s) hereby waives any and all claims against the Church, its pastoral
staff, directors, officers, employees, volunteers, agents, and other members that
relate to financial coaching services or the consequences that may occur as a
result of following the advice given.  Any disputes that may arise between
Participant(s) and the Church shall be resolved by mediation.

Indicate your agreement by filling in your name and date below

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The Financial Coaching ministry of Providence Church is intended to provide basic financial knowledge that is aligned with scripture. We are not licensed to provide tax, legal, or investment advice. If any information of this nature is given during a coaching session, it is solely the view of the volunteer and is not endorsed nor advised by Providence Church. Please acknowledge that you understand that information of this nature should not be provided through this ministry and that you release Providence Church and its volunteers from any liability regarding the outcomes of acting upon such information