SERVICES AGREEMENT, ASSUMPTION OF RISK, RELEASE OF CLAIMS, AND INDEMNITY
This is a letter of agreement. By agreeing to Terms and Conditions on the Mission Volunteer Form, you are indicating that you have read this Agreement carefully, understand what it means, and agree to all of the terms below.
For and in consideration of being allowed to participate in the activity of international medical volunteer services (“Program”), organized by Mammoth Medical Missions, I hereby agree:
- To consult with my personal physician about necessary immunizations and any other medical matters relating to my participation in the program.To voluntarily identify to Mammoth Medical Missions any personal, physical, and/or psychological or emotional problems I might have which would, without reasonable accommodation, prevent me from performing my responsibilities as a volunteer. I understand that if I have a disability which requires reasonable accommodation by Mammoth Medical Missions, I will advise Mammoth Medical Missions at a time sufficiently prior to the commencement of the program to allow Mammoth Medical Missions to make reasonable accommodations.
- That there are certain inherent risks associated with volunteer duties in an international setting. These include risks involved in traveling to, and returning from, one or more foreign countries; 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. I represent that I have made my own investigation and am willing to accept these risks and I assume full responsibility for personal injury to myself and further release and discharge Mammoth Medical Missions for injury, loss or damage arising out of my use of or presence upon any facilities, whether caused by the fault of myself or other third parties.
- I authorize Mammoth Medical Missions to grant permission for my necessary medical treatment for which I will be financially responsible if, during my participation in the Program, I become incapacitated or otherwise unable to provide consent to medical treatment and advance consent cannot be obtained from my family. I am aware of potential personal medical costs. I recognize that Mammoth Medical Missions is not obligated to attend to any of my medical or medication needs, and I assume all risk and responsibility for such needs. If I require medical treatment or hospital care in a foreign country or in the United States, Mammoth Medical Missions is not responsible for the costs or quality of such treatment or care. Mammoth Medical Missions may (but is not obligated to) take any actions it considers to be warranted under the circumstances regarding my health and safety. I agree to pay all expenses relating to such actions and release Mammoth Medical Missions from any and all liability.
- To be personally responsible for any financial liability and obligation which I personally incur and for any injury, loss damage, liability, cost or expense to the person or property of another which is caused or contributed to by me during my participation in the Program. I understand that Mammoth Medical Missions does not represent or act as an agent for, and cannot control the acts or omissions of, any host institution, host family, transportation carrier, hotel, tour organizer, or other provider of goods or services involved in the Program. And understand that Mammoth Medical Missions is not responsible for matters that are beyond its control, including, without limitation, strikes, war, loss or theft of personal belongings, delays, weather, acts of God, governmental restrictions, or acts, errors, omissions, or negligence of any third party, including but not limited to any provider of goods or services.To abide by all applicable laws and respect the customs and culture of the country where the Program is conducted. I understand I must personally attend to any legal problems I encounter or incur as a volunteer in the host country.
- Assumption of Risk and Release of Claims. KNOWING THE RISKS AND RESPONSIBILITIES DESCRIBED ABOVE, AND IN CONSIDERATION OF BEING PERMITTED TO PARTICIPATE IN THE PROGRAM, I AGREE, ON BEHALF OF MY FAMILY, HEIRS, AND PERSONAL REPRESENTATIVE(S), TO ASSUME ALL THE RISKS AND RESPONSIBILITIES SURROUNDING MY PARTICIPATION. I AGREE TO AND HEREBY RELEASE, DEFEND AND INDEMNIFY MAMMOTH MEDICAL MISSIONS, ITS PARTNERS AND AFFILIATES, AND THEIR TRUSTEES, OFFICERS, EMPLOYEES AND AGENTS FROM AND AGAINST ANY AND ALL PRESENT OR FUTURE CLAIM, DAMAGES, ATTORNEY FEES, EXPENSES, LIABILITY, CLAIMS, OR DEMANDS FOR PERSONAL INJURY, SICKNESS, OR DEATH, AS WELL AS FOR PROPERTY DAMAGE AND EXPENSES OF ANY NATURE WHATSOEVER, THAT MAY BE INCURRED OR SUFFERED BY ME, OR FOR WHICH I MAY BE LIABLE TO ANY OTHER PERSON, DURING MY PARTICIPATION IN THE PROGRAM OR ARISING FROM DIRECT RELIEF’S AND HOSPITAL BERNARD MEV’S NEGLIGENCE CONNECTED THEREWITH (INCLUDING DURING PERIODS IN TRANSIT TO OR FROM ANY COUNTRY WHERE THE PROGRAM IS BEING CONDUCTED).
- And acknowledge that Mammoth Medical Missions will provide necessary local ground transportation and camping location and that volunteer will otherwise be responsible for flight costs to and from Mission Location, meals, hotel accommodations after work days, as well as all vaccinations, personal affects, incidentals or any costs deemed not associated with the assignment by Mammoth Medical Missions.
- To be flexible during the Program, and to keep detailed records of my experience, such as conditions of the site, accommodations and daily activities in order to provide a thorough account of my overall experiences.
- To complete the post-assessment trip form upon my return from the Program. I understand that the information I provide will be kept by Mammoth Medical Missions staff and directors for their records of my trip so they can have a better understanding of the processes used and conditions of the site to which I was deployed.
- And acknowledge that any agreement that may be entered into by Mammoth Medical Missions and/or any affiliate, based on this form may, at the sole option of Mammoth Medical Missions be deemed void and ineffective if any of the preceding application information is not complete, true and accurate.
- That submission of this request does not constitute approval or acceptance to Mammoth Medical Missions as a staff member, affiliate, or network provider.
- That all permissions granted will expire upon completion of any work that I am assigned or otherwise accepted by Mammoth Medical Missions or termination of the Program whichever occurs earlier.
- MEDIA POLICY:
- PROPRIETARY RIGHTS:
I further acknowledge that I am at least sixteen years of age and am participating in this Program voluntarily. If I am under 18 years of age my parents have submitted required Parental Permission and Release of Liability forms. I have carefully read this Agreement before signing it. No representations, statements, or inducements, oral or written, apart from the foregoing written statement, have been made to me.