GO, LOVE, SERVE, U.S.A.

If you are under the age of 18, please have a parent or legal guardian complete and sign this form. Thank you.
NOTE: If you plan to stay on campus, please bring either twin bedding or a sleeping bag and pillow. And, please consider a love offering for the Place of Grace also.

Emergency Contact Information

Please enter the name of the person who should be contacted in the case of an emergency.

Release and Waiver of Liability

I, the undersigned participant, hereby acknowledge that I am a legal adult and agree that my participation in the GO, LOVE, SERVE Trip organized by CHC World Missions and Place of Grace is entirely voluntary. In consideration of being allowed to participate in this trip, I hereby agree to the following terms and conditions: Assumption of Risk I understand that participating in the GO, LOVE, SERVE Trip involves inherent risks and dangers, including but not limited to travel risks, physical activities, potential exposure to illness, and various environmental conditions. I hereby assume all risks associated with my participation in this trip. Release of Liability I hereby release, waive, and discharge CHC World Missions, Place of Grace, their officers, directors, employees, agents, volunteers, and any other representatives from any and all liability, claims, demands, actions, or causes of action arising out of or related to any loss, damage, injury, or harm of any kind, including death, that may occur during my participation in the GO, LOVE, SERVE Trip. Indemnification I agree to indemnify and hold harmless CHC World Missions, Place of Grace, their officers, directors, employees, agents, volunteers, and any other representatives from any and all claims, demands, actions, or causes of action, including attorney’s fees and costs, arising out of or related to my participation in the GO, LOVE, SERVE Trip. Medical Treatment I consent to receive medical treatment deemed necessary if I am injured or become ill during the trip. I understand and agree that I am solely responsible for all costs related to such medical treatment, including transportation expenses. Personal Responsibility I understand that it is my responsibility to ensure my own safety and well-being during the trip. I agree to follow all instructions and guidelines provided by trip leaders and to act in a manner that is respectful and considerate of others and the environment. Binding Effect This Release and Waiver of Liability shall be binding upon me, my heirs, executors, administrators, and assigns, and shall inure to the benefit of CHC World Missions and Place of Grace and their respective successors and assigns. I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, FULLY UNDERSTAND ITS TERMS, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.