HOLDHARMLESS AGREEMENT ROTARY DISTRICT 5240

WHEREAS, Rotary International, Inc. has designated February 7th and8th, 2010 as National Immunization Days in India, herein referred to as NID’s; and

WHEREAS, Rotary Districts 5240 and various districts in India are participating in NID’s on saiddates for the purpose of administering oral polio vaccine for immunization to children in various areas ofIndia; and

WHEREAS,Anil Garg, a member of the Rotary Club of Simi Valley is organizing a trip to India from California for Rotarians and Rotary friends in District 5240 and other districts wishing to participate in NID’S as volunteers on the above mentioned dates; and

WHEREAS, Participating Rotarians and Rotarian friends will depart the USA for Indiaon or about February 2nd, 2010, and return to the USA from India on or about February 13th,2010; and

WHEREAS, Said Rotarian and Rotary friends acknowledge each is serving as avolunteer without expectancy of compensation or financial reimbursement forparticipating in the NID’S; and

WHEREAS, Said Rotarian and Rotarian friends are responsible for their own expenses, including airfare, lodging and food during the stated period; and

WHEREAS, the undersigned, as a Rotarian or Rotary friend, desires to participate as a team member in the NID’S events, as described herein; and

WHEREAS, the undersigned participant acknowledges receiving a general code of conduct and rules concerning the behavior of team members while being hosted in India; and

WHEREAS, the code of conduct and rules referred to herein were derived for the purpose of avoiding misconduct of team members that could jeopardize or harm the team, its purpose, or its hosts in India; and

WHEREAS, the undersigned participant acknowledges the unfettered discretion of the team leaders to remove any participant from the team, including the undersigned, for any action or conduct the team leader feel inappropriate or in violation of the rules referred to herein and thatsuch removalmayresult in preventing the removed participant from any further participation in the NID’S event.

NOW THEREFORE, It is agreed as follows:

You the undersigned participant volunteerwill save and hold harmless, Anil Garg and the participating Districts and Rotary Clubs from any and all liability for loss or damage or injury you may incur in any manner arising out of or incident to their performance set forth above, including without limitation all consequential damages.

You, the undersigned, hereby acknowledge the possibility of civil unrest and terrorism in areas outside the United States and in India. Although it is not the intent of Anil Garg or the participating Rotary Districts or Rotary Clubs to knowingly frequent any dangerous areas or subject you or any participant to such danger, the possibility of such a confrontation with dangerous civil disobedience does exist. You agree to save and hold harmless Anil Gargand the participating Rotary Districts and Rotary Clubs from any and all liability for loss or damage or injury you may incur as a result of your participation in this NID’S event.

You, the undersigned, agree your participation in this event is at your own risk, and you are agreeing to save and hold harmless Anil Garg and the participating Rotary Districts and Rotary Clubs from any loss or damages you may incur whatsoever as a result of your participation in this event.

You the undersigned, acknowledge you have read this “Hold Harmless” agreement, understand its contents and the legal consequences thereof, and you are signing this document under your own free will, without any duress or undue influence exerted by Anil Garg andthe participating Rotary Districts and Rotary Clubs members, or any other person(s).

______

Signature

Print Name: ______

Date: ______, 2009

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