Participation in Samaritan’s Purse activities may involve travel to developing countries where modern luxuries and medical care are not available. You might encounter extreme weather conditions, pollution, physical exertion, and contaminated food and water. It is up to you and your medical provider to ensure that you are healthy enough to participate in these activities. Please bring a supply of any medications you may need. If you have any known allergies or asthma that may require immediate attention, you MUST bring your own reaction kit (i.e., epi-pen, inhaler, etc.).

Immunizations

You are responsible for obtaining all required immunizations for the country in which you are traveling. If assigned to a malarial area, you will need to take a malaria prophylaxis. Please consult with your physician or local Health Department for immunization recommendations for the area(s) in which you are traveling.

Insurance

Some personal life or medical insurance policies have exclusions for illness, injury or death occurring in an international destination. It is your responsibility to acquire appropriate insurance for the duration of your Samaritan’s Purse activities.

This Assumption of Risk, Waiver, Release and Indemnification (the “Agreement”) is executed as of the latest date written below. I, the undersigned participant in Samaritan’s Purse Youth (“SPY”) Teams ministry activities, in consideration of Samaritan’s Purse (“SP”) allowing my participation in this ministry opportunity, acknowledge and agree as follows:

Assumption of Risk

Participation in SPY Teams activities includes travel to and work in areas of the world characterized by hazardous conditions, including possible risks such as land mines and unexploded ordnances, unstable governance and security, political unrest, damaged buildings and infrastructure, contaminated food and water, disease, natural disasters, and poor or limited access to medical care. In addition, the U.S. State Department recommends that U.S. citizens traveling abroad maintain a high level of vigilance and increase their security awareness as U.S. citizens may be targets of terrorist actions or kidnapping. I acknowledge that I am aware of and assume responsibility for these and other related risks.

Waiver, Release and Indemnification

I hereby waive, release and forever discharge and hold harmless SP, its employees, representatives, and agents from any and all actions, claims, and liabilities arising out of injury to or damage sustained by me, including claims for personal injury, death, property damage or any other loss related to my participation in SPY Teams activities. I further agree to indemnify SP against any and all liability, claims, or actions arising out of damage or injury to persons or property caused by me.

Code of Conduct

I understand and agree that SP is a Christian organization and that my conduct while engaging in SPY Teams activities must be in conformity with general principles of Christian conduct, as determined in the sole discretion of SP. If I fail to abide by such standards, my participation in SPY Teams activities may be cut short and I may be sent home early with no refund of monies received by SP and at my expense.

No Benefits

I understand that I am not an employee of SP and am not entitled to employee benefits from SP including, without limitation, accident, travel, life, disability or health insurance, pension benefits, or compensation for work performed. I understand that my personal life or medical insurance coverage may have exclusions for death, illness, or injury occurring in a war risk or international destination. I acknowledge that I am responsible for and have been advised to acquire appropriate travel or war risk life and health insurance for the duration of the SPY Teams program activity and that I am responsible for my own medical and life insurance coverage.

SP Use of Intellectual Property

I hereby authorize and grant to SP an irrevocable, royalty-free perpetual license to reproduce, display, distribute, publish or otherwise lawfully use any photographs, film footage or other media taken by me during SPY Teams activities. I grant to SP the right to reproduce, display, distribute, publish or otherwise lawfully use my name, image, likeness, statement and/or testimonial as depicted in any medium and taken as a result or during SPY Teams activities. SP may use my name, image, likeness, statement and/or testimonial for any SP purpose, including, without limitation, in any marketing or promotional material. I waive any claim against SP related to use of intellectual property including, without limitation, any claim of copyright infringement or any claim related to the right of publicity, right of privacy, defamation, and/or right of reimbursement.

Emergency Medical Treatment

In the event of injury to me, I hereby consent to and authorize any medical treatment or tests considered advisable or necessary in the judgment of SP staff or any qualified medical personnel.

Entire Agreement; Choice of Law

I acknowledge that this Agreement contains the entire understanding of the parties relating to the subject matter contained herein and supersedes any other written or oral communications. This Agreement may be amended only by a written document signed by both parties. This Agreement shall be governed by and interpreted in accordance with the laws of the State of North Carolina, without respect to conflict of laws provisions.

Minor Participants

If participant is a minor child under age 18, he/she may only participate in SPY Teams activities with the permission of a parent or legal guardian with the legal authority to act on the child’s behalf. By signing below, the parent or legal guardian hereby agrees to all the terms and conditions contained in this Agreement on behalf of the minor child.
Accepted and agreed:

Financial Expectations

As a trip participant, I accept the invitation to join Samaritan’s Purse through their Samaritan’s Purse Youth Teams in an excursion to Guyana, which will occur between the dates of July 19-July 25, 2014 and do hereby acknowledge and accept the responsibility to raise $2200—$3000. I understand that tax receipts will be issued for all gifts to the fullest extent allowed by the law. Once receipted, all gifts are non-refundable.

Behavior/Conduct

I understand that on this trip, I am not only representing myself, but my church/group, Samaritan’s Purse, and the national ministries I will be working and associated with. What I do will affect the work of the team and the national ministries. Therefore, while I am on this trip, I will refrain from smoking, drinking alcohol, or the use of narcotics. I will also respect the guidance of the Samaritan’s Purse team leader. Failure to do so may result in being sent home early at my own expense with no refund of monies raised.

Dress Code

I understand that in the countries where Samaritan’s Purse leads short-term mission trips, my physical appearance is very important to the local church. While I am in the country, I will adhere to all dress codes enforced by Samaritan’s Purse.

Contact with Home

I accept that contact with friends and family at home will be limited to emergency situations only. The Samaritan’s Purse team leader will have the means to contact the Samaritan’s Purse office in the event of an emergency only and vice versa.