Waiver of Liability Policy

I do hereby certify that I am willing, physically fit and will be sufficiently prepared to travel with Heartline Foundation.

I understand that I travel and serve at my own risk and Heartline Ministries or Heartline Foundation is not liable in the event of sickness, accident, death or terrorist acts. I understand that the U.S. State Department currently issues travel advisories for specific countries at risk to travel overseas. I understand that travel into such countries may be hazardous and involve the risk of injury, sickness and possibly death, as well as damage to property when traveling to and from and within such countries. I understand that I may travel and live in very underdeveloped areas, risk violence from crime, war, terrorism, political unrest and other dangers, and may be exposed to food and water-borne diseases and to diseases from other carriers. I understand that some diseases may not produce symptoms during the actual trip, but may occur after the trip. I understand also that medical facilities in such countries may not be of the quality of medical facilities in the United States.

I understand that it is my responsibility to maintain a current knowledge of travel advisories, medical advisories, or other risks until my departure and while I am on location with Heartline Ministries/Heartline Foundation (info available at TRAVEL.STATE.GOV).

Should it be necessary for me to return home due to medical reasons, disciplinary action, or other reasons not directed by Heartline Ministries/Heartline Foundation I will assume total transportation costs incurred above the original ticket cost of the trip. My estate and my family will further assume full and total cost for the return and shipping of my body should I die by any cause on this trip.

I acknowledge that I have read and completed Heartline Ministries/Heartline Foundation’s Medical Release Form and have delivered this form to Heartline Foundation’s designated team leader for this trip.

I agree wholeheartedly to abide by decisions made by leaders and those in authority on this trip.

I, the undersigned, agree to the above and have voluntarily and without duress signed this WAIVER OF LIABILITY.  I am a volunteer participating in this activity with Heartline Ministries/Heartline Foundation. I agree to hold Heartline Ministries/Heartline Foundation harmless and without fault regardless of the circumstances, injury, illness, or even death should it occur as a result of my participation. We (I and my heirs) hold harmless Heartline Ministries/Heartline Foundation, its Board of Directors, Trustees, employees, and anyone associated with Heartline Ministries/Heartline Foundation in perpetuity.

Your Name

Signature

Date

Parent/Legal Guardian (Name)