Intake

I consent to the Turning Leaf program and its staff obtaining a record of my criminal background and
using the information from that report in determining my eligibility and job placements.

The execution of this form does not authorize the release of information other than that described below. I authorize the Turning Leaf Project staff to share the following specific information with: Who I allow my information to be shared with:
-SC Department of Probation, Parole, and Pardon services
-Social service organizations (housing, food, clothing, educational, medical)
-Family Members or Friends, including those on my support team
-Mental Health and substance abuse treatment providers including but not limited to Charleston Dorchester Center for Behavioral Health and the Charleston Center
-Job partners and potential job partners. Job partners are people and/or companies that are interested in or agreeing to hire Turning Leaf Participants.
-My employer
The information may be shared in person, by phone, or by e-mail. What information about me will be shared: I consent to the Turning Leaf Project to share information about me, including: my current criminal charges, my behavior in the community after release, my progress/setbacks regarding treatment goals, referrals to community agencies, the results of my risk assessments, the results of my drug tests, my
attendance at group and meetings, strategies involving sanctions or incentives, employment status, living or family situation and immediate needs including food, clothing, and transportation. I understand: Consent to this release form is completely voluntary. I understand that this release is valid when I sign it and that I may withdraw my consent to this release at any time by written notification. Without written notification to withdraw this consent, it does not expire.
GENERAL VIDEO/PICTURE/AUDIO RELEASE FORM
Photographer & Videographer: Amy Barch, Joseph McGrew or those authorized by Turning Leaf to take pictures or videos. I hereby consent to the use and reproduction by Turning Leaf staff and anyone authorized by Turning Leaf staff to use photographs or other types of images, voice recordings and/or
video that you have taken of me or recorded, with or without my name, for the purpose of promoting activities and/or any other purposes, including the purpose of advertising or illustrating to anyone the work of Turning Leaf of I understand and agree that I am entitled to no compensation at all if my photographs or other types of images, voice recordings and/or video are used.
RELEASE OF LIABILITY
I will receive the Turning Leaf Participation Agreement and I have the opportunity to ask questions about it. I understand my obligations under this Agreement and I am entering this Agreement voluntarily. I understand and agree that as I am not an employee or independent contractor of Turning Leaf Program, if I am injured while participating in the program, I am not eligible for workers’ compensation benefits. Further, I understand and agree to hold Turning Leaf Project harmless for any injuries that occur to me while I am a participant in the program and to indemnify Turning Leaf Program from any and all liability associated with my participation in the program to the fullest extent possible.

I understand that some classes and meetings could happen online through video chatting services and that some communication will happen through email. I know and understand the privacy concerns of online communication and I do not hold Turning Leaf liable for data breaches if they occur.

-You must work in our screen printing shop Monday through Friday as part of program participation. Any other jobs you get must work around that schedule unless getting permission from your case manager.
-If you miss a full day in the first two weeks, you must restart and forfeit any earned points up to that point.
-If you ever No Call/No Show to any class, shift, meeting, or job, you are removed from the Turning Leaf and it is your responsibility to meet with your case manager within 24 hours.
-It is your responsibility to know the expectations outlined in this agreement.