Crucible® Neurobiological Therapy Clinical Workshop
By my signature below I acknowledge reading and agreeing to the foregoing “Workshop Policies” and specifically agree to the following:
- I am disclosing potential conflicts of interest (if any) on the form provided.
- I agree not to use or infringe upon trademarks owned or pending by the Crucible Institute or David Schnarch, Ph.D., which include (but are not limited to) “Crucible”, “Sexual Crucible,” “CrucibleApproach,” Passionate Marriage” Passionate Couples,” “Four Points of Balance,” I will make no use of these marks without prior written permission.
- I recognize the Crucible Institute and David Schnarch, Ph.D., as owners of copyright rights in and to the workshop lectures and materials, including but not limited to the course handbook, slides, and training materials. I agree not to reproduce or distribute these materials in any form or part or derivative works, or by any means, electronic or mechanical, including but not limited to photocopy, recording, or any information storage and retrieval system, without prior written permission.
- I agree to make no commercial use of materials, lectures, or other proprietary information disclosed during this workshop beyond their application in direct service mental health practice with individuals, couples, or families, or in group therapy without prior written permission.
- If I do not wish to abide by the “Workshop Policies,” or decline to complete the “Conflict of Interest Disclosure” or sign this “Workshop Agreement,” my registration fees will be refunded. I understand the Marriage & Family Health Center reserves the right to refuse participation in the workshop to those who do not complete and return these materials.
Conflicts of Interest Disclosure
We don’t want our interactions with you during this workshop to be based on one set of premises, while other agendas are operating underneath. Therefore, we are raising important issues mental health professionals often ignore. When not dealt with thoroughly and openly in advance, they tend to be handled poorly if and when they surface later. Below we ask you to disclose any potential conflicts of interest you may have with us, or any you might reasonably anticipate. These include (but are not limited to) workshops, trainings, business applications, publications, and other materials you are preparing or planning to develop or conduct that may overlap with our work in general, and specifically, the topics and content of this workshop. Also include pending or foreseeable legal actions in which you are involved, which might include us or arise from your participation in this workshop. If you are a practitioner or a trainer of a trademarked therapy or educational approach, please identify yourself as such.