I hereby state the following:
a) That I am physically fit and have no medical condition that would prevent me from performing the volunteer services for which I am applying;
b) That I take full responsibility for obtaining all my immunizations and personally paying the costs;
c) That I am aware that there are hazards and risks to my person and property associated with the overseas short term missions activities for which I am applying. Such hazards and risks include, but are not limited to; death, disability, loss of ability to maintain earnings, loss of property, illness, disease, inadequate and /or unavailable medical services, weather conditions, trip delays, unlawful detention, terrorist acts, war, criminal acts, and wild animals;
d) That I agree to be solely responsible to provide and care for my own personal health, as well as my belongings.
I HEREBY ASSUME ALL OF THE RISKS set forth above, as well as any risks related thereto, which may result in injury, death, property damage, property confiscation, etc. and I agree to volunteer my services on behalf of the above mission, despite the hazards and risks set forth above.
I HEREBY RELEASE FROM ALL LIABILITY the Roman Catholic Diocese of Charleston (and its Bishops, agencies, employees, agents, and any affiliated organizations) for any and all claims for damages for personal injuries to myself and to my property or any damages resulting from delays in being returned to the United States.
I HEREBY AGREE TO HOLD HARMLESS and to indemnify and reimburse the Roman Catholic Diocese of Charleston (and its Bishops, agencies, agents, and employees and affiliated organizations) for any and all claims that are brought against the Diocese and its Bishops and agents, and for all expense (including attorney’s fees) that the Diocese may incur as a result of any claims presented against them, for any of my injuries and losses, or for any of my conduct related to said mission trip.