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ASTra - Request Support Form

You must be a member of Nebraska Hands & Voices to receive Advocacy Support services. A membership is $25/year and includes additional benefits. If cost is a concern, please request a family scholarship. 

How did you hear about ASTra?
How can we assist you?
Are you receiving advocacy support from another person or agency?

ASTra Release of Liability

ASTra Advocates have been trained through the Hands & Voices ASTra Educational Advocacy Program as lay advocates. ASTra Advocates provide information and support to parents who have requested educational advocacy and support. ASTra Advocates do not provide legal advice or represent that their advice equates to legal counsel. Nothing in the relationship between the parent requesting support and the ASTra advocate should be construed as legal advice. Hands & Voices strongly recommends that anyone seeking legal advice get an attorney. 

I, for and in consideration of the provision of ASTra Advocacy services, the receipt and sufficiency of which is hereby acknowledged, do hereby release and forever discharge Nebraska Hands & Voices and all its representatives, and Hands & Voices HQ and all and any of its representatives, their agents, employees, successors and assigns, and their respective heirs, personal representatives, affiliates, successors and assigns, and any and all persons, firms or corporations liable or who might be claimed to be liable, whether or not herein named, none of whom admit any liability to the undersigned, but all expressly denying liability, from any and all claims, demands, damages, actions, causes of action or suits of any kind or nature whatsoever, which I now have or may hereafter have, arising out of or in any way relating to any and all injuries and damages of any and every kind, to both person and property, and also any and all injuries and damages that may develop in the future, as a result of or in any way relating to the provision of ASTra Advocacy services by Nebraska Hands and Voices.

It is understood and agreed that the provision of services is made and received in full and complete settlement and satisfaction of the causes of action, claims and demands mentioned herein; that this Release contains the entire agreement between the parties; and that the terms of this Agreement are contractual and not merely a recital. Furthermore, this Release shall be binding upon the undersigned, and his respective heirs, executors, administrators, personal representatives, successors and assigns. This Release shall be subject to and governed by the laws of the of Nebraska.

This release has been read and fully understood by the undersigned and has been explained to me. By checking this box, I understand that I am agreeing to the terms and conditions laid out in the ASTra Release of Liability.

Thanks for reaching out! We'll be in touch soon.

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