API USA • Adult Travel Authorization, Medical & Liability Releases
For Adults 18 Years and Older
Travel Authorization
Release of Liability
The undersigned desires to travel to one or more foreign countries on a mission trip organized by Agape Project International USA. I, my heirs, representatives and assigns do hereby release and forever discharge Agape Project International USA and their respective members, employees, officers, directors and representatives from any and all claims for any and all injuries (including death), losses or damages I might have and or sustain in any way relating to such trip, including, without limitation, those relating to my leaving the U.S.A. and visiting foreign countries, including any stay in any such foreign country and to and from any such country.
I understand that travel, particularly on a foreign mission trip, may involve significant risks and that some areas of the world involve greater health and safety risk than foreign travel in general. I understand it is my sole responsibility to gather whatever information I need to assess my risk in such travel, stay or activity expected during this trip. My signature on this RELEASE and my participation in any such activity means I have to my full satisfaction obtained the information necessary to assess the risk and to participate willingly.
Medical Release
I hereby give Agape Project International USA and its representative(s) authority to request and authorize medical and/or hospital treatment for my benefit in the event of any injury or sickness sustained by me during this trip. I agree to pay for all such treatment and/or to reimburse Agape Project International USA for all costs and expenses incurred by them with respect for such treatment.
Binding Christian Arbitration
I am a Christian and believe the Bible commands Christians to make every effort to live at peace and to resolve disputes with each other in private or within the Christian church (see Matt 18:15-20 & 1 Cor 6:1-8). Therefore, I agree any claim or dispute arising from or related to this Release Form shall be settled by biblically based mediation and, if necessary, legally binding arbitration in accordance with the Rules of Procedure for Christian Conciliation of the Institute for Christian Conciliation. Judgment upon an arbitration award may be in any court otherwise having jurisdiction. I understand these methods shall be the sole remedy for any controversy or claim arising out of this Release Form and I expressly waive any rights I have to file a lawsuit in any civil court for such disputes, except to enforce an arbitration decision.
Authorized Signature
I am 18 years of age or older and these RELEASES are binding on me and my executor, administrators, heirs and assigns. I have fully read the above and agree to be bound to the terms and conditions of this document.
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Signature Printed Legal Name Effective Release Date
Return As Soon As Possible to: API USA, P.O. Box 235047, Encinitas, CA 92023-5047 API USA 12/10