Release and Assumption of Risk Form

RELEASE AND ASSUMPTION OF RISK
1. I acknowledge that I have voluntarily applied for enrollment in the above listed short term mission trip and in consideration of being permitted to participate in such trip, do voluntarily execute this “Release and Assumption of Risk” in behalf of myself, my heirs and next of kin, my personal representative and my estate. 2. I acknowledge that I have been fully informed of the nature, scope and demands of the trip, and that I have met all of the prerequisites required for participation in this trip. 3. Many churches sponsor short-term mission trips. These trips usually involve a number of risks that may not be covered by insurance. The form below is for use by members and/or volunteers of the church who participate on a trip that involves travel inside and outside of the United States. It is quite likely that the church will not have insurance to cover injuries or accidents that occur on such trips, and typically, the church has no means of adequately supervising all activities involved on the trip. As a result, a church may ask members/volunteers who participate on such trips to assume all risks associated with them as a condition of their participation. In such cases, a form similar to this one is often used. 4. I am aware of the hazards and risks to my person and property associated with serving in a mission’s capacity, such hazards and risks including, but not being limited to, death or injury by accident, disease, war, terrorist acts, weather conditions, inadequate medical services and supplies, criminal activity, and random acts of violence. I accept my assignment with full awareness of these risks, and, subject to any insurance coverages that may be available to me from any source, and only with respect to my church and its agents, officers, directors, and employees, I voluntarily assume all risks of death, injury, and illness associated with such risks, and any damage to my personal property, and I release my said church and its agents, officers, directors, and employees from any liability whatever arising as a result of death, injury, or illness that I may suffer as a result of participation in the missions trip. I further recognize that such risks have always been associated with missionary service. 2 Corinthians 11:23-28. 5. I understand that every care and attention will be given to the health and comfort of the members/volunteers, but the church or its staff cannot be held liable for any injuries sustained which were not directly caused by their failure to take due care. 6. I hereby authorize the leader of the trip to secure such medical advice and services as may be deemed necessary for the health and safety of myself (or my son/daughter/ward) and I agree to accept financial responsibility, including in excess of the benefits allowed by provincial health insurance plans: a. Where the health and wellbeing of the applicant is involved. b. Where all attempts to contact the parent or guardian have failed or where due to the nature of the emergency there was insufficient time to contact such parent or guardian. It shall be at the discretion of the leader of the church as to what action must be taken for the welfare and safety of the member/volunteer. 7. I accept and assume full responsibility for all harm and injury, of every nature, including death, which may occur to me or which I may suffer, and for all damages or loss to any personal property or property issued to me by Oak Cliff Bible Fellowship, while I am participating in the trip and, in furtherance thereof, I agree to indemnify and holder harmless Grace Pointe Assembly of God, and its employees, from and against any and all claims, demands, actions or causes of action, on account of damage to personal property, or to my personal injury, or death, which may occur or result directly or indirectly from my participation in the activity, and which results from causes beyond the control of and without the fault or negligence of Grace Pointe Assembly of God and its employees. 8. I agree to abide by the rules and regulations imposed on participants by the agency and its staff. 9. I agree that I will be cooperative and helpful to and with all other participants in the trip and will not be disruptive of the objectives established for the trip or as may be designated by the staff or group consensus. 10. I declare that I am in good physical health and believe that I am able without reservation or limiting conditions to physically withstand and cope with the indicated activities of this trip. 11. I request that this “Release and Assumption of Risk” be construed and interpreted pursuant to the laws of the State of Tennessee, and if any portion thereof is held invalid, I request that the reminder continue in full force and effect.
Date
Date
Name
Name
Address
Address
Date
Date
Parent/Guardian (if under 18)
Parent/Guardian (if under 18)
Address 1
Address 1