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Couple Disclaimer

Your typed names in the spaces below will serve as your electronic signatures for this form and indicate that you have read and understand this disclaimer. It also indicates that you are making a voluntary, informed choice to enter a Marriage Mentoring relationship with a self-selected or assigned mentor couple.
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- PLEASE READ CAREFULLY
  
  The Marriage Mentoring process cannot begin until this disclaimer is signed by both spouses.
  
  1. Marriage Mentoring is a process that can help people make decisions about how to attain goals that the couple set for themselves.
  
  2. All discussions held as a part of the Marriage Mentoring process will be held in the strictest confidence.
  
  3. Marriage Mentoring is not a form of therapy, nor are Marriage Mentors licensed therapists.
  
  4. No Marriage Mentor couple nor the Diocese of Davenport may be held responsible in any way for any decision a person makes as a result of the mentoring he or she has received.
  
  5. Neither the Marriage Mentor nor The Diocese of Davenport may be held liable in any way for any of the results of any Marriage Mentoring received or any decisions made or any actions taken by any couple as a result of these decisions.
  We have read and agree to the five statements on this Disclaimer Form. Please select this field.
- Husband’s Signature REQUIRED Please fill out this field. Please enter valid data.
- Date Format: MM-DD-YYYY below
- Date REQUIRED Please fill out this field. Please enter a date.
- Wife’s Signature REQUIRED Please fill out this field. Please enter valid data.
- Date Format: MM-DD-YYYY below
- Date REQUIRED Please fill out this field. Please enter a date.
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- Faith Formation