In 500 words or less – please tell us your story describing the financial and/or medical situation, as well as how assistance from the CEA would be used. If your income has been impacted, please indicate the extent of that as well. Please be specific about the amount of assistance requested, and how this would provide relief. (Example: The patient has no insurance and $142 would pay for prescriptions.)
By submitting this form, you acknowledge
By submitting this form, you acknowledge…
That all assistance, financial or other provided by Colorado Event Alliance are overseen by the Treasurer in accordance with the policies established by the Board of Directors. The Colorado Event Alliance (“CEA”) provides situational financial assistance up to $999.99 to members of Colorado’s special event community find themselves in need of assistance.
Neither CEA nor any of its officers, directors or volunteers makes any representation regarding the care provided by any medical, mental health, dental, chiropractic or other provider. By accepting any assistance from CEA, whether in the form of financial distribution(s), financial distributions to any third-party on your behalf, or volunteer services, you warrant that you have done and will continue to do your own due diligence regarding the qualifications of any individual or institution from which you receive services of any kind. You further warrant that you have done and will continue to do your own due diligence regarding the nature and standard of care you receive from any medical, mental health, dental, chiropractic, or other provider.
By accepting assistance from CEA, you also forever waive any claim you may have against CEA, its officers, directors or volunteers for any damages you may incur that are in any way connected to any medical, mental health, dental, chiropractic, or other services you may receive. You agree that you will indemnify and hold CEA harmless for the same. You further agree that you will be responsible for any attorney fees or costs incurred by CEA and its officers, directors or volunteers in defending themselves against any claim brought by you in any judicial or administrative proceeding.
Anonymity of recipients is presumed and fully protected, unless and until that person chooses to tell their story and/or give a testimonial. Award applicants will not make any disparaging remarks or take any other action that could reasonably be anticipated to damage the reputation and goodwill of CEA. CEA does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or operations. These activities include, but are not limited to, selection of board members, officers, volunteers, vendors along with provision of services. We are committed to providing an inclusive and welcoming environment for all associated with the organization, including board members, volunteers, subcontractors, vendors, award applicants and recipients. Please do not send any private or secure information such as medical records or social security numbers. Once you have submitted the application, you will be contacted by the Award Distribution Committee.