This is a liability wavier for the Students Without Borders Trip to Morrito Nicaragua.
Students Without Borders Remote Activity Waiver
This Release and Waiver of Liability (“Waiver”) executed on ________________, 2008, by ______________________, is in favor of Students Without Borders, a nonprofit, their directors, officers, employees, managers, coordinators and agents (collectively, “Students Without Borders”).
By affixing your signature below, you as the undersigned are affirming that you have read this waiver and agree with all of its terms and conditions. You are not permitted to travel to and /or participate in any Students Without Borders activity in any city, state, or locale other than your residence without agreeing to the terms and conditions, and signing this Waiver.
Intent to Participate of Own Free Will You, the undersigned, have decided of your own free will that you want and intend to participate in a Students Without Borders activity out of the city, state and/or local of your residence (“ Students Without Borders Remote Activity”), and you are under no obligation to do so. You also hereby freely, voluntarily, and without duress execute this Waiver under the following terms:
Release and Waiver Participation in any Students Without Borders Remote Activity, either for volunteering or social purposes, which is outside of your immediate residential area and requires travel, is at your own risk. Students Without Borders assumes no liability for accidents, injuries, illness, or damages associated with participation the Remote Activity, or traveling to or from the city in which the Remote Activity is taking place (“Remote City”), or events which occur while you are in the Remote City.
You hereby affirm that you release and forever discharge and hold harmless Students Without Borders and its successors and assigns from any and all liability, claims and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from your participation in the Students Without Borders Remote Activity
Travel To and From Remote City It is your responsibility to determine your means and method of travel to and from the Remote Activity. Travel to and from the Remote Activity is not sponsored by Students Without Borders, and any suggestions, arrangements or assistance Students Without Borders or any of its representatives provides you in identifying, obtaining, reserving or purchasing your travel itinerary or fare, or your lodging, for traveling to or from and while at the Remote City, is for your convenience and your assistance only. You may choose whatever method of travel and carrier you wish. Students Without Borders does not warranty or guarantee any travel method or carrier, whatsoever.
Travel Within the Remote City In addition, any travel you participate in while at or near the Remote City (such as, but not limited to, local busses, taxis, private vehicles, boats, trains etc.) is at your own risk, and not warranted by Students Without Borders.
Personal Conduct Travel always carries with it an element of risk and it is your responsibility to conduct yourself and use your judgment in a reasonable manner to keep yourself safe from harm during travel to and from and during your stay in the Remote City where the Students Without Borders Remote Activity is taking place. It is your responsibility alone to be familiar with and conduct yourself according to any national, state or local laws or ordinances. Under no circumstances is Students Without Borders liable for any activity that takes place by, to, or around you in the Remote City.
Condition of Participating You may be removed from the Remote Activity and asked to leave the Remote City for possessing illegal drugs, or engaging in violence, vandalism, illegal activities or other conduct deemed detrimental to or incompatible with the safety, interest, harmony, comfort or welfare of the other participants in the Remote Activity. If you are removed from the Remote Activity, you alone will be responsible for finding and funding your travel home, and for any lodging, travel, or other costs that cannot be cancelled and/or refunded.
Indemnity You, the undersigned, agree to indemnify and hold harmless Students Without Borders from any and all losses, injuries, damages, demands or claims arising out of or in connection with the Students Without Borders Remote Activity, including the amount of any damages, demands or claims or judgments against you, and any attorneys fees, expenses and/or court costs.
Participant’s Signature affirming the above: ________________________________
Date signed: _____________
Participant’s Name: __________________________________
Participant’s Address: ___________________________________________________
Participant’s Phone Number:_____________________________
Participant’s E-Mail: __________________________________
Participant’s Date of Birth: ________________
Participant’s Emergency Contact: (Name): __________________________________ (Relationship): _____________________________ (Phone number): ____________________________ (Address): ___________________________________________________