Mt. Carmel Veterans Service Center UCCS Veteran Health
and Trauma Clinic
Family Care Center
& Colorado Veterans Health and Wellness Agency
Fountain-Fort Carson
School District 8
UCCS Veteran and Military Affairs Office of Warrior Care Policy VA Eastern CO HCS,
Colorado Springs Clinic
RMHS-Homes for All Vets Vet Center Colorado Veterans
Resource Coalition

As a Military & Veteran Service Organization Partner

I understand and agree that I will be referring Participants from my organization, agency, or institution to receive cultural enrichment experiences from Artist Facilitators working as Independent Contractors to the Military Arts Connection (MAC) program. I understand and agree that my referrals will be made possible through the allocation of free electronic credits provided to my organization, agency, or institution by the Cultural Office of the Pikes Peak Region (Cultural Office), and may be used at my discretion solely for the benefit of service members, veterans and military dependents Participants residing in the Pikes Peak region (El Paso and Teller Counties, Colorado). I understand and agree to refer only Participants to the MAC program who are mentally and emotional stable enough to engage in, and benefit from, the intended cultural enrichment experiences.

While the Artist Facilitators in the MAC program will all receive at least four hours of Military Cultural Competency training prior to providing any services, I understand and acknowledge that the Artist Facilitators will likely not be certified Creative Arts Therapists, and that the services they will provide through the MAC program shall be solely for cultural enrichment and education purposes, and shall not be advertised, considered, promoted, provided, or intended as therapy or medical treatment. I also understand and acknowledged that the Artist Facilitators are agreeing to keep private and confidential all names and details of their engagements and interactions with MAC program Participants, unless expressly permitted to be disclosed per a signed writing by the applicable program Participant.

On behalf of and as duly authorized by my organization, agency, or institution, I hereby release and forever discharge the Cultural Office and its MAC program partners, inclusive of their trustees, directors, officers, equity stakeholders, representatives, successors, assigns, agents, and employees, from any and all claims, demands, and causes of action, of whatever kind or nature, either in law or in equity, arising from, or in any way connected with the referral of any Participant to the MAC program.

As an Artist Facilitator and Independent Contractor

I understand and agree that I am not an employee of the Cultural Office of the Pikes Peak Region (Cultural Office), and that I am not insured under the Cultural Office’s workers compensation policy. Therefore, any injuries I may incur during the performance of my work as an independent contractor are not covered by workers’ compensation insurance. In the event of an injury requiring medical care, I, or my personal health insurance, will be responsible for payment of all medical costs. I further understand and agree that I am not covered by the Cultural Office’s liability insurance policy, nor any other insurance policy, nor may I be entitled to protection from liability under the Colorado Governmental Immunity Act.

I further understand and agree that the services I will be providing as an Artist Facilitator for the Military Arts Connection (MAC) program shall be provided solely for cultural enrichment and education purposes, and shall not be advertised, considered, promoted, provided, or intended as therapy or medical treatment. I also agree to keep private and confidential the names and details of my engagements and interactions with MAC program Participants, unless expressly permitted to be disclosed per a signed writing by the applicable program Participant.

With full comprehension of the potential consequences of this decision, I hereby agree to and do assume all risk of injury to myself and my property which I may suffer as a result of my service as an Independent Contractor for the MAC program. On behalf of myself as well as my heirs, administrators, executors, and assigns, I hereby release and forever discharge the Cultural Office and its MAC program partners, inclusive of their trustees, directors, officers, equity stakeholders, representatives, successors, assigns, agents, and employees, from any and all claims, demands, and causes of action, of whatever kind or nature, either in law or in equity, arising from, or in any way connected with, injuries or property damage sustained by me, or injuries or property damages caused by me, in connection with my providing services as an Independent Contractor/Artist Facilitator for the MAC program. 

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