Missions :: Adult Liability Form (18 Years +)


This Liability Form is a a required part of your Westgate missions trip application.

Your digital signature below constitutes a binding contract with DOVE Westgate Church and is considered the same as your handwritten signature. By signing below, you are indicating your agreement with the terms and conditions as listed. Please fill out form in its entirety.

Only one form per applicant. Spouses must complete separate forms.

If you have any questions, please contact Pastor Wes Dudley, Missions Director, at wesd@dwchurch.org.
Date

Select One Only:

Participant Release, Assumption of Risk, and Hold Harmless Agreement


PLEASE REVIEW THOROUGHLY BEFORE SIGNING ::

In consideration of being permitted to participate in this missions trip with DOVE Westgate Church, including travel to and from the mission site (collectively referred to as "DWC Mission Trip Service") and for services of DOVE Westgate Church, their respective agents, employees, trustees, officers, directors, volunteers, sponsors, successors and assigns, and all others acting in any capacity on their behalf to conduct the DWC Mission Trip Service, I HEREBY AGREE TO RELEASE, DISCHARGE, INDEMNIFY AND HOLD HARMLESS DOVE WESTGATE CHURCH, ON BEHALF OF MYSELF, MY SPOUSE, MY CHILDREN, MY PARENTS, MY HEIRS, ASSIGNS, PERSONAL REPRESENTATIVES AND ESTATE AS FOLLOWS:

1. I acknowledge that engaging in this DWC Mission Trip Service entails both known and unknown risks that could result in illness, severe physical and emotional injury, paralysis, death, or damage or loss of property. These risks include, but are not limited to: accidents in the course of travel to and from the destination(s); risk of injury or illness commonly associated with construction, recreation or other missionary service activities (including the risk of negligent acts or omissions), weather-related incidents, and risks associated with living and working in regions with underdeveloped security, buildings, roads, sanitation, food, water, and health care services and facilities. I understand that such risks are inherent to and cannot be eliminated from DWC Mission Trip Service.

2. I understand that DWC Mission Trip Service entails travel in countries and regions where there may be a risk of criminal or terrorist activity.

3. I acknowledge that my participation in DWC Mission Trip Service is purely voluntary, and I expressly agree to accept and assume all risks associated with my participation in DWC Mission Trip Service. I specifically agree to accept and assume the risk that DOVE Westgate Church may commit negligent acts or omissions during the DWC Mission Trip Service. I also agree to accept and assume the risk that any injuries or illness I may suffer during the DWC Mission Trip Service may be made worse by negligent treatment or rescue efforts by DOVE Westgate Church, or other third parties.

4. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless DOVE Westgate Church, its pastors, its elders, its deacons, its staff members, its volunteers, its congregants, and my DWC Mission Trip Service Team Leader(s) and Team Members from any and all claims, demands, or causes of action, which in any way arise from or are related to my participation in DWC Mission Trip Service, including all claims alleging negligence if I am injured or become ill in any way during DWC Mission Trip Service.

5. In the event that I or any legal representative acting on my behalf files a lawsuit against DOVE Westgate Church, I agree to do so solely in the Superior Court of the State of Pennsylvania, County of Lancaster. I further agree that Pennsylvania substantive law shall apply without regard to the conflict of law rules of Pennsylvania or any other state or nation. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.

6. I represent that I am at least 18 years of age and otherwise competent to sign this Release of Liability agreement. This Release of Liability & Indemnification Agreement shall be binding to the fullest extent permitted by law. If any part of this release is deemed to be unenforceable, the remaining terms shall be enforceable as a contract between parties. This release shall be binding upon my assignees, subrogors, heirs, next to kin, executors and personal representatives.

By signing this document, I acknowledge that I may be found by a court of law to have waived my right to maintain a lawsuit against DOVE Westgate Church, including claims that DOVE Westgate Church has committed negligent acts or omissions. I have had a sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms.

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