Waiver for Professional Liability Insurance

Dare to Lead Facilitator Certification

Waiver for Professional Liability Insurance

Proof of professional liability/indemnity/E&O insurance is a requirement of the Dare to Lead Facilitator Certification program. Applicants who will facilitate Dare to Lead Curriculum only within their sponsoring organization may sign a waiver for professional liability insurance.

All applicants must be full-time employees of the organization.

_____________________ (applicant name) waives the requirement for proof of professional liability/indemnity/E&O insurance by acknowledging the following: (please initial)

____ I confirm I am a full-time employee of the sponsoring organization

(organization name) : _____________________________________.

____ I confirm I will only facilitate Dare to Lead Curriculum within my organization for employees of my organization.

____ I confirm I will not offer Dare to Lead Curriculum outside of my organization.

Signature:

Email:

Phone number:

Date: