(“Volunteer”) and Mainsprings the Janada L. Batchelor Foundation for Children, Inc. (“Mainsprings”).
By signing and submitting this form, I agree that this Liability Waiver may be transacted electronically, and I agree that I will be bound by the terms and conditions set forth herein and by my electronic signature on this Liability Waiver form.
I further affirm that this Agreement and Release is entered into in connection with the program offered by Mainsprings (“Program”) under which Mainsprings provides the opportunity for Volunteer to participate in volunteer service and cultural exchange. Volunteer enters into this Agreement and Release in consideration of the opportunity to participate in the Program and for other good and valuable consideration, the sufficiency of which the parties acknowledge.
All remaining program fees must be paid six weeks prior to the start of your trip. Payments may be made by check, credit cards through our website (www.mainsprings.org) or by calling (918)706-2268. Checks should be made payable to Mainsprings. All payments must indicate the name(s) of the volunteer(s) for whom they’re intended.
Refunds for Cancellation or Withdrawal Cancellation by Mainsprings
At any time prior to the Program start date, Mainsprings may, at its sole discretion, cancel a Volunteer’s registration, or cancel the Program in which Volunteer is scheduled to participate. In the unlikely event of such a cancellation, the total amount paid to Mainsprings by Volunteer for that program, excluding the payment for airfare and the $200 registration fee, will be refunded. Other than in such circumstance, Mainsprings will not be responsible to the Volunteer for any other refund, costs, interest, liability, losses, or damages of any kind.
Withdrawal by Volunteer
If Volunteer withdraws for any reason, Volunteer must notify Mainsprings in writing. Such withdrawal will not be effective until received in writing by Mainsprings at its offices at the address set forth below. Mainsprings incurs substantial costs with respect to each Program. Therefore, if Volunteer voluntarily withdraws from the Program, funds paid by Volunteer to Mainsprings will not be refunded. In the case of some extreme emergencies, exception may be granted by the CEO.
Alterations to Program
Mainsprings reserves the right to change the Program due to severe weather, acts of war or terrorism, or other causes beyond our control. In such cases we will make our best effort to offer alternate dates for travel. Mainsprings will not be responsible for any additional costs associated with such circumstances. If Volunteer withdraws from the Program due to such causes, the same withdrawal policy as above will remain in effect.
Volunteer’s Responsibility for Costs, Third Party Suppliers
The Program fee covers all food, water, lodging, in-country ground transportation, administrative expenses, and program costs. Volunteer is responsible for
1) travel to and from the start location,
2) any additional costs incurred during free time, personal time, or on activities which are outside the Program, and
3) any costs incurred should Volunteer withdraw early from or remain past the time scheduled for the Program.
Mainsprings is not responsible for the acts or failures to act of anyone who provides goods or services in connection with the Program. In addition, Mainsprings is not responsible for any costs, losses, damages, interest, overages, or penalties that Volunteer may incur because of delays or losses caused by any airline, other transportation or car rental company, travel agent, hotel, restaurant, medical facility, or other individual or organization providing goods or services, regardless of who arranged or paid for such goods or services, or because of any act or failure to act by any governmental entity, including any delay or change of travel plans caused by any action by any governmental entity.
Dismissal from the Program
Mainsprings has the authority at any time and in its sole discretion to dismiss Volunteer from the Program. Mainsprings personnel may discuss Volunteer’s situation, including Volunteer’s health, physical, or mental condition, with any person, including other Mainsprings personnel, family members, or medical personnel, and release any information concerning Volunteer to such person. If Volunteer is dismissed from the Program, Mainsprings will provide transport to the appropriate airport or will arrange for other means of departure. Volunteer will be responsible for all costs incurred as a result of such dismissal, and there will be no refund of all or any portion of the Program Fee.
Donations Restricted to Benefit Volunteer
All donations made by third parties to underwrite the costs of a Volunteer’s Program fee are nonrefundable. Personal Property Loss Mainsprings takes all reasonable measures to ensure the security of Volunteer’s personal belongings. However, petty theft occurs worldwide. Mainsprings will not be held responsible for the loss of, or damage to, Volunteer’s personal property or equipment. Mainsprings strongly advises Volunteer not to bring expensive or irreplaceable items including, but not limited to, cameras, computers, portable music players, cell phones, other electronic equipment, and/or jewelry to the Program.
Emergency Medical Treatment
Should any medical emergency arise which precludes Volunteer’s ability to consent to emergency treatment, Mainsprings will endeavor to communicate with the person designated by Volunteer to request permission for any necessary treatment. If Mainsprings personnel believe, in their sole discretion, that time or circumstances do not permit such communication, Volunteer authorizes Mainsprings to consent on his or her behalf to any medical treatment, including all types of medical examinations, diagnosis, medication, or physician or hospital care, that is deemed advisable by, and is to be rendered under the general or special supervision of any hospital, medical clinic or physician. Volunteer agrees not to hold Mainsprings responsible for actions or consequences relating to any such medical or emergency treatments or the failure to provide such medical treatment.
Use of Volunteer’s Likeness
Volunteer consents to the use of Volunteer’s likeness (whether photographed, filmed or videotaped) and/or oral or written comments or any portion thereof, in any manner now or in the future, including, without limitation, in fund-raising and promotional materials, advertising for television, radio, print or other media, and any other Mainsprings presentations or publications. Volunteer agrees that, in connection with such use, Mainsprings, and persons acting for or on behalf of Mainsprings, may identify Volunteer by name, age, city and/or state or country of residence.
Acknowledgement, Waiver, Release, Indemnification and Hold Harmless
Volunteer acknowledges that the Program involves travel to a developing country with a possibly unstable political system and differing cultural expectations and practices. Volunteer acknowledges that there are risks inherent in such trips, including, but not limited to, forces of nature accident or illness in remote places without immediate access to adequate medical facilities, a lower standard of 2016 Volunteer Handbook 33 sanitation, work site injury, and travel by air, automobile, truck, on foot or by other conveyance.
As consideration for participation in this program, and of the services, food and transportation arranged by Mainsprings, the undersigned acknowledges, appreciates, understands, and agrees to the following:
I acknowledge and understand that there are risks of loss, both to person and to property, associated with participation in the Program including but not limited to: concussion, fractures, scrapes, aches, pains, cuts, tears, bruises, paralysis, or death. I EXPRESSLY AND VOLUNTARILY ASSUME THE RISK OF DEATH OR OTHER PERSONAL INJURY ASSOCIATED WITH PARTICIPATION IN THE PROGRAM, WHETHER OR NOT CAUSED BY THE NEGLIGENCE OR OTHER FAULT OF MAINSPRINGS, and further accept that there are also risks that may arise due to the actions of other participants, which I also expressly and voluntarily assume.
I, for myself, and on behalf of all of my heirs, assigns, representatives, and next of kin whatsoever, and on behalf of the participant, if the participant is under the age of 18, agree to RELEASE, HOLD HARMLESS, AND INDEMNIFY MAINSPRINGS, and its successors, liability insurance carriers, officers, directors, employees, and agents (hereinafter sometimes "the Releasees"), from any and all liability, claims (including for personal injury and property damages), demands, causes of action or damages that I may hereafter have for injuries or damages arising in any way from participation in the Program or while on or upon the premises where the Program is being conducted, and arising in any way from the consent to Emergency Medical Treatment given herein and in the Minor Volunteer Health Information, Authorization for Disclosure of Protected Health Information, and Consent for Medical Treatment of a Minor, EVEN IF CAUSED BY THE NEGLIGENCE OR OTHER FAULT OF THE RELEASEES.
I, for myself, and on behalf of all of my heirs, assigns, representatives, and next of kin whatsoever, and on behalf of the participant, if the participant is under the age of 18, additionally agree to INDEMNIFY AND HOLD HARMLESS RELEASEES from all claims, judgments and costs, including but not limited to attorney's fees, and to reimburse them for any expenses whatsoever incurred in connection with an action brought as a result of my participation in the Program.
This Waiver, Release, Indemnification and Hold Harmless Agreement shall be construed in accordance with the laws of the State of Oklahoma and the location (venue) for any action between MAINSPRINGS and me and/or the participant, if the participant is under the age of 18, and/or any of our heirs, assigns, representatives, or next of kin whatsoever will be in Tulsa County, Oklahoma.
I am in good physical condition and have the physical ability to participate in the Program and am legally competent to understand and complete this agreement. I acknowledge that this is the entire Agreement and that no contrary or conflicting representations, inducements or promises, orally or otherwise, have been made by anyone to induce me to sign this Agreement. I have read this Agreement and hereby execute this Agreement without coercion.