By copying this page and emailing it to email@example.com, I confirm that I am 18 years of age or older and that I agree to voluntarily participate in an event arranged by Reach Out & Learn, Inc., which may include training professionals, humanitarian service, and other activities in and around: Lima, Cusco, Abancay, the Sacred Valley, Aguas Calientes, Puno, and the surrounding and rural areas in Peru, from April 21st to April 29th 2023 or while traveling to and from any and all events and activities arranged by Reach Out & Learn. It is my intention to perform voluntary service without compensation for Reach Out & Learn, Inc. in the professional training events and/or humanitarian-type service efforts and activities in Peru which may include travel within Peru during my time in Peru in training events, humanitarian activities, medical/leadership training meetings, tourism, indigent care, general service labor, educational activities, or other events and activities in Peru, and in areas surrounding the places mentioned above, including travel to and from activities in rural villages.
In consideration of Reach Out & Learn, Inc.'s agreement to permit me to participate in this event, the receipt and sufficiency of which is hereby acknowledged, I agree as follows:
1. Risks of Humanitarian Event: I understand that participation in the humanitarian event involves risks involved in traveling to and within, and returning from humanitarian-event locations; foreign political, legal, social, and economic conditions; different standards of design, safety, and maintenance of buildings, public places, and conveyances; and local medical and weather conditions. The location in which I perform the humanitarian-event related activities may have health and safety standards different from those enjoyed in the United States and my local community, and I recognize that I may be subjected to potential risks, illnesses, injuries, or death. I have made my own investigation of these risks, understand these risks, and assume them knowingly and willingly. I also acknowledge that in working, living, and traveling in other cities and abroad, I may experience problems associated with urban living, including increased crime, pollution, high population density or standards of living and health standards that are not equivalent to life in the United States and my local community. I acknowledge that I must take every precaution to safeguard my health and to protect my personal belongings from damage or theft. I acknowledge that Reach Out & Learn, Inc. recommends that I never travel alone, particularly at night. Being alone, particularly at night, may present additional danger to my safety and well-being. I understand that in the event of injury of any kind I will not under any circumstances receive any type of compensation through Reach Out & Learn, Inc., except as otherwise specifically agreed to in advance and in writing. I have read the project description, and am aware of the possible hazards. I am aware that in volunteering I may incur personal injury and/or property damage. I desire to release Reach Out & Learn, Inc. from any financial responsibility for any personal injury and/or property damage I may incur as a result of my voluntary service, even when it results from the negligence of Reach Out & Learn, Inc. or its officers, volunteers, employees, agents, or representatives.
2. Health Insurance and Medical Care. I agree that I have or that I will purchase travel insurance that covers me from the time I leave my home to travel to Peru until the time I return to my home from Peru, or I affirm that I carry valid and current medical insurance and have a valid insurance identity card to bring. I have determined that this insurance is adequate to cover injuries or illnesses that I may sustain while performing humanitarian-event related activities, including the expenses of returning me to the United States in the event that such action is necessary. I certify that I am free of any conditions that would endanger my life, health, or well-being while working or participating in humanitarian-event related activities or that would otherwise impede my ability to fully participate in all aspects of the humanitarian-event. I recognize that Reach Out & Learn, Inc. is not obligated to attend to any of my medical or medication needs, and I assume all risk and responsibility therefore. If I require medical treatment or hospital care during the humanitarian-event, Reach Out & Learn, Inc. is not responsible for the cost or quality of such treatment of care. However, each officer of Reach Out & Learn, Inc. and its representatives and designees is authorized (but is not obligated) to take any actions it considers to be warranted under the circumstances regarding my health and safety, including but not limited to, placing me under the care of a doctor in a hospital or any other appropriate place for medical examination and/or treatment or returning me to the United States at my own expense if such return is deemed appropriate or necessary. I agree to pay all expenses relating thereto and release each of such persons from any liability for any such actions. Should the need arise Reach Out & Learn, Inc. is authorized to provide any personal information about me to any health care provider, including my personal medical records if deemed necessary.
3. Standards of Conduct. I understand that I will be responsible for my personal safety at all times. I recognize that I assume an important personal obligation to conduct myself in a manner compatible with local laws and regulations, and with Reach Out & Learn, Inc. rules and standards. I promise to act responsibly and will become informed of, and will abide by, all such laws, regulations and standards. I will comply with Reach Out & Learn, Inc.'s humanitarian-event rules, standards, and instructions for participant behavior. I agree that Reach Out & Learn, Inc. has the right to enforce the standards of conduct described above, in its sole judgment, and that it will impose sanctions on me for violating these standards or for any behavior detrimental to or incompatible with the interest, harmony, and welfare of Reach Out & Learn, Inc. and the humanitarian-event. I agree that if my participation is terminated, I will be solely responsible for all expenses incurred up to the time of termination and for all expenses incurred in returning to my point of origin.
4. Institutional Arrangements. I understand that Reach Out & Learn, Inc. does not represent or act as an agent for, and cannot control the acts or omissions of, any host employer, transportation carrier, hotel, motel, tour organizer, or other provider of food, goods, or services involved in the humanitarian-event. I understand that Reach Out & Learn, Inc. is not responsible for matters that are beyond its control. I hereby release Reach Out & Learn, Inc. from any injury, loss, damage, accident, delay, or expense arising out of any such matters.
5. Independent Activity. I understand that Reach Out & Learn, Inc. is not responsible for any injury, loss or delay I may suffer when I am traveling independently.
6. Foreign Travel. I further agree that: a) If traveling to a foreign country for this humanitarian-event, I have a valid passport; if I do not have a U.S. passport, I have made sure that I either do not need a visa in connection with the humanitarian-event or I have obtained an entry visa; and b) I am solely responsible for any legal problems I encounter with any foreign nationals or government of the host country. I also acknowledge that (1) Reach Out & Learn, Inc. is not able to assist humanitarian-event participants who break the law in a foreign country and is not responsible for legal fees or other costs while attempting to secure my release from foreign custody, and (2) neither Reach Out & Learn, Inc. nor the United States government has the ability to protect me from punishment with respect to drugs and other criminal offenses I may perpetrate in a foreign country.
7. Acknowledgment of Risk and Release of Claims. Knowing and acknowledging the risks described above, I agree, on behalf of myself, my family, heirs, and personal representative(s), to assume all the risks and responsibilities surrounding my participation in the humanitarian-event. To the maximum extent permitted by law, I release, hold harmless, and agree to indemnify Reach Out & Learn, Inc., its humanitarian-event coordinators, or Program Director, Executive Director, trip organizers, and its officers, staff, representatives, volunteers, employees, and agents, from and against any present or future claim, loss, or liability for injury to person or property which I may suffer, or for which I may be liable to any other person, during my participation in the humanitarian-event (including periods in transit to or from any location and/or country where the humanitarian-event may be taking place), resulting from any cause including but not limited to Reach Out & Learn, Inc.'s, its Board of Directors', Executive Director's, officers', staff's, representatives', volunteers', employees', or agents' own passive or active negligence or other acts other than fraud, willful misconduct, or violation of the law. I hereby release Reach Out & Learn, Inc. and its officers, agents, volunteers, employees, and representatives, and waive all claims against them, for any personal injury (including death) and/or property damage I may incur as a volunteer, including damage incurred as a result of the negligence of any officer, volunteer, employee, agent, or representative of Reach Out & Learn, Inc.. No promise, inducement, or agreement has been made to me to induce me to release Reach Out & Learn, Inc. for any personal injury and/or property damage incurred by me as a result of my voluntary services, nor has any promise, inducement, or agreement been made to me in return for the express waiver of rights referred to above.
I have carefully read this Acknowledgment of Risk, Release from Liability, and Waiver of Claims form before signing it. This agreement shall be governed by laws of the State of Utah, which shall be the forum for any lawsuits filed under or incident to this agreement or my participation in any activity or humanitarian-event of Reach Out & Learn, Inc. I agree that the prevailing party in any legal action relating to this agreement or my participation in any Reach Out & Learn, Inc. event or activity shall be entitled to recover of its costs and attorney's fees incurred in any such action.
Please Note: Photos will be taken throughout our time in Peru and some photographs will be posted on our web site, Facebook page, or on digital or printed promotional material. Please let us know (firstname.lastname@example.org, 801-505-1840 or during the event) if you do not wish to have your picture made public. By signing up, the attendee grants Reach Out And Learn Inc permission to use his/her likeness in a photograph in any and all publications and materials without payment or consideration made to them.
IN WITNESS WHEREOF, the undersigned executes this Acknowledgment of Risk, Release from Liability, and Waiver of Claims to be effective upon signature and the date written below.
Reply to this email as your agreement to the terms of this participation waiver.
Your reply will be sent to email@example.com and maintained by the directors as your agreement and willingness to the participation terms given in this waiver agreement.