Adult Participants – Individuals

Sign up by filling out the form & consent below and click SUBMIT
Once you have signed up below, you may request a Visit.
Once an Ambassador has signed up for your Visit, you will receive confirmation and the Ambassador will connect with you using the information you have provided.
After your first Visit, you will receive a link to our survey (because we welcome your comments, questions and suggestions!) and instructions for requesting additional Visits with your Ambassador and/or other Ambassadors.
Questions? Comments? Suggestions? Please email visits@sweetreaders.org and we will follow up with you!
- Unique ID*
- Adult Participant Name*
  First Last
- Zip Code*
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  Birth Year
- Birth Year*
- Who is signing up?*
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  Name
  First Last
- Email*
  Enter Email Confirm Email
- Phone/text*
- Home Address
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- Which is your preferred method of communication?*
  
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  Text
  
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- Your Name*
  First Last
- Your Email*
  Enter Email Confirm Email
- Your phone/text*
- Which is your preferred method of communication?*
  
  Email
  
  Text
  
  Phone
- How did you hear about Sweet Readers CONNECT?
- Please describe
- Which Media?
- Special Requests
- Consent Terms & Conditions
- The Consent below must be signed by the personal legally responsible for the Adult Participant. Please have that person read the terms & conditions, sign their name, by writing /Their Name/ in the box indicated below, click the I AGREE box and then click SUBMIT.
- Adult Participants – Individuals Release THIS IS A LEGAL DOCUMENT – PLEASE READ CAREFULLY BEFORE AGREEING Sweet Readers, Inc. ("Sweet Readers") is a 501(c)3 tax exempt public charity formed in New York, New York, USA in 2011. Our mission is to empower young people through training, transformative programs and communities of support to engage adults living with Alzheimer's disease and related disorders ("AD") and become catalysts for excellence in eldercare. During our programs, young people are challenged to utilize science, human engagement and the arts to discover the person and meaningfully connect. To alleviate the stress, anxiety and isolation caused by COVID-19, Sweet Readers has developed a remote access program, Sweet Readers CONNECT ("The Program") to empower young people to bring light and joy into the lives of any and all isolated adults in need. Young People ("Ambassadors") will be connecting with their adult partners ("Adult Participant") and possibly an aid or care provider ("Care Partner") for 15-30 minute remote Visits ("Visit") via FaceTime, Zoom, WhatsApp and other technology. The Visits will include lively conversation and possibly any of our many remote modules including Music & Voice, Movement & The Five Senses, Collaborative Poetry, Creative Stories, etc. I may also participate in school and after-school group versions of The Program, some of which may include trained facilitators. On behalf of yourself, an isolated adult in need, or an older adult in your care (you being the person legally responsible for the Adult Participant), you are signing up to participate in the Program. We are delighted to be able to include you in these special remote Visits. On behalf of myself or the Adult Participant in my care, I acknowledge and agree: • Visits will be scheduled on a weekly basis through the Sweet Readers CONNECT web site: Connect.sweetreaders.org. Once I have submitted this form, I will be issued an ID number, to be used to schedule a Visit. I agree to make best efforts to attend every Visit I have signed up for, including Group Visits, which may be scheduled directly with Sweet Readers staff. if am running late or need to cancel, I will immediately email visits@sweetreaders.org and put “RUNNING LATE” or “NEED TO CANCEL A VISIT” in the subject line of the email. • As part of scheduling a Visit, I shall provide whatever contact information will be necessary for Ambassador to connect with Adult Participant (whether myself or someone in my care), including but not limited to the cell phone number, aid name, and/or other technology connect details. • Sweet Readers will use best efforts to ensure Connect information is only given to the Ambassador for purposes of the Program. • Once a match has been established for an Ambassador or pair of Ambassadors to Visit with the Adult Participant, Ambassador(s) will follow contact guidelines set forth by Sweet Readers, to make the connection. • Following initial School, After-School or any other initial Visit, I may participate in additional Visits by following instructions emailed or texted to me by Sweet Readers after each Visit. • Visits will fill on a first-come-first served basis. • Sweet Readers reserves the right to end any Visit or remove any participant or group from the Program as deemed appropriate by Sweet Readers' sole judgement and discretion. • I will use best efforts to ensure no inappropriate language or texts are communicated between the Adult Participant, Care Partner and Ambassador(s). • I will ensure any contact information provided by Ambassador to Care Providers or Adult Participant is used only for Program purposes and not distributed to third parties. • For privacy purposes, Sweet Readers CONNECT communications, outside of Sign Up here, is strictly on a first name basis. By signing below, on behalf of myself or the person in my care, I hereby irrevocably and voluntarily consent to and authorize Sweet Readers to use any photographs, audio and/or videos (“Images”) captured during the Program and Visits by me or any other participant, care provider, facilitator or administrator, on behalf of Sweet Readers or any school, eldercare or museum partner, or any artworks, including but not limited to musical pieces, poetry, stories and any texts that may be sent between the participants and/or the participants and any of the program partners (“Artworks) created as part of or in connection to The Program to promote the Sweet Readers Mission in any medium or media. I also agree not to distribute any Images without Sweet Readers prior written consent. Sweet Readers agrees not to publish the last name of any program participants without their express prior written consent and to take great care not to post any imaging of any participants that would cause them harm. I further acknowledge that Sweet Readers is the exclusive owner of all rights in and to the aforementioned Images and Artworks. By signing below I agree to allow the Adult Participant and Care Partner to participate in the Program and hereby release and will indemnify and hold harmless Sweet Readers, its employees, officers, directors, agents and representatives, to the fullest extent permitted by applicable law, from all claims, demands and liability of any kind including without limitation, all personal injuries including loss of life and expenses including reasonable attorney's fees, arising either the Adult Participant's or Care Partner's participation in the Program, the use of third party technology platforms (for scheduling, Zoom, FaceTime, WhatsApp, etc.), unauthorized distribution of any personal information and/or the display, distribution, reproduction or other use of the Works, excluding claims arising directly from the willful misconduct or grossly negligent acts of Sweet Readers. The indemnity set forth in this paragraph shall survive termination of this Release. By signing below, I warrant that I have the right to enter into this Agreement, including, without limitation, on behalf of the Adult Participant and acknowledge and agree to the aforementioned terms and conditions which I have carefully read and reviewed.*
  Adult Participants – Individuals Release
  
  THIS IS A LEGAL DOCUMENT – PLEASE READ CAREFULLY BEFORE AGREEING
  
  Sweet Readers, Inc. ("Sweet Readers") is a 501(c)3 tax exempt public charity formed in New York, New York, USA in 2011. Our mission is to empower young people through training, transformative programs and communities of support to engage adults living with Alzheimer's disease and related disorders ("AD") and become catalysts for excellence in eldercare. During our programs, young people are challenged to utilize science, human engagement and the arts to discover the person and meaningfully connect.
  
  To alleviate the stress, anxiety and isolation caused by COVID-19, Sweet Readers has developed a remote access program, Sweet Readers CONNECT ("The Program") to empower young people to bring light and joy into the lives of any and all isolated adults in need. Young People ("Ambassadors") will be connecting with their adult partners ("Adult Participant") and possibly an aid or care provider ("Care Partner") for 15-30 minute remote Visits ("Visit") via FaceTime, Zoom, WhatsApp and other technology. The Visits will include lively conversation and possibly any of our many remote modules including Music & Voice, Movement & The Five Senses, Collaborative Poetry, Creative Stories, etc. I may also participate in school and after-school group versions of The Program, some of which may include trained facilitators.
  
  On behalf of yourself, an isolated adult in need, or an older adult in your care (you being the person legally responsible for the Adult Participant), you are signing up to participate in the Program.
  
  We are delighted to be able to include you in these special remote Visits.
  
  On behalf of myself or the Adult Participant in my care, I acknowledge and agree:
  
  • Visits will be scheduled on a weekly basis through the Sweet Readers CONNECT web site: Connect.sweetreaders.org. Once I have submitted this form, I will be issued an ID number, to be used to schedule a Visit. I agree to make best efforts to attend every Visit I have signed up for, including Group Visits, which may be scheduled directly with Sweet Readers staff. if am running late or need to cancel, I will immediately email visits@sweetreaders.org and put “RUNNING LATE” or “NEED TO CANCEL A VISIT” in the subject line of the email.
  
  • As part of scheduling a Visit, I shall provide whatever contact information will be necessary for Ambassador to connect with Adult Participant (whether myself or someone in my care), including but not limited to the cell phone number, aid name, and/or other technology connect details.
  
  • Sweet Readers will use best efforts to ensure Connect information is only given to the Ambassador for purposes of the Program.
  
  • Once a match has been established for an Ambassador or pair of Ambassadors to Visit with the Adult Participant, Ambassador(s) will follow contact guidelines set forth by Sweet Readers, to make the connection.
  
  • Following initial School, After-School or any other initial Visit, I may participate in additional Visits by following instructions emailed or texted to me by Sweet Readers after each Visit.
  
  • Visits will fill on a first-come-first served basis.
  
  • Sweet Readers reserves the right to end any Visit or remove any participant or group from the Program as deemed appropriate by Sweet Readers' sole judgement and discretion.
  
  • I will use best efforts to ensure no inappropriate language or texts are communicated between the Adult Participant, Care Partner and Ambassador(s).
  
  • I will ensure any contact information provided by Ambassador to Care Providers or Adult Participant is used only for Program purposes and not distributed to third parties.
  
  • For privacy purposes, Sweet Readers CONNECT communications, outside of Sign Up here, is strictly on a first name basis.
  
  By signing below, on behalf of myself or the person in my care, I hereby irrevocably and voluntarily consent to and authorize Sweet Readers to use any photographs, audio and/or videos (“Images”) captured during the Program and Visits by me or any other participant, care provider, facilitator or administrator, on behalf of Sweet Readers or any school, eldercare or museum partner, or any artworks, including but not limited to musical pieces, poetry, stories and any texts that may be sent between the participants and/or the participants and any of the program partners (“Artworks) created as part of or in connection to The Program to promote the Sweet Readers Mission in any medium or media. I also agree not to distribute any Images without Sweet Readers prior written consent. Sweet Readers agrees not to publish the last name of any program participants without their express prior written consent and to take great care not to post any imaging of any participants that would cause them harm.
  
  I further acknowledge that Sweet Readers is the exclusive owner of all rights in and to the aforementioned Images and Artworks.
  
  By signing below I agree to allow the Adult Participant and Care Partner to participate in the Program and hereby release and will indemnify and hold harmless Sweet Readers, its employees, officers, directors, agents and representatives, to the fullest extent permitted by applicable law, from all claims, demands and liability of any kind including without limitation, all personal injuries including loss of life and expenses including reasonable attorney's fees, arising either the Adult Participant's or Care Partner's participation in the Program, the use of third party technology platforms (for scheduling, Zoom, FaceTime, WhatsApp, etc.), unauthorized distribution of any personal information and/or the display, distribution, reproduction or other use of the Works, excluding claims arising directly from the willful misconduct or grossly negligent acts of Sweet Readers. The indemnity set forth in this paragraph shall survive termination of this Release.
  
  By signing below, I warrant that I have the right to enter into this Agreement, including, without limitation, on behalf of the Adult Participant and acknowledge and agree to the aforementioned terms and conditions which I have carefully read and reviewed.
  I AGREE TO THE CONSENT TERMS & CONDITIONS LISTED ABOVE
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Consent Terms & Conditions