AGREEMENT AND RELEASE
THIS AGREEMENT AND RELEASE is between the volunteer (“Volunteer”) and Bridges to Community, Inc. (“BTC”). This Agreement and Release is entered into in connection with the program offered by BTC (“Program”) under which BTC 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.
If Volunteer is younger than 18 years of age, this Agreement and Release must be signed by a parent or legal guardian of Volunteer, and, in such case, all references below to Volunteer include his or her parents or guardian. This document is a legally binding release, which, in certain situations, will reduce or eliminate Volunteer's legal rights and legal recourse. Please read it carefully before signing.
By choosing to submit this form as an electronic document, your completion of the checkboxes and signature fields below will be considered the same as your signature on a printed document. By completing these fields and submitting this document, you are agreeing to the terms and policies contained herein.Payment Policy
If we purchase an airline ticket for you, your airfare must be paid in full when we make the reservation. The completed Volunteer Program Application, a copy of the photo page of your passport, and the remainder of the Program Fee must be submitted no later than thirty (30) days prior to the start of your trip.
Payments may be made by credit card via telephone, fax, online, or by regular mail. We accept Visa, Mastercard, and American Express. We will also accept checks made payable to Bridges to Community, Inc. All payments must indicate the name(s) of the volunteer(s) for whom they're intended, as well as the dates of the Program.Refunds for Cancellation or WithdrawalCancellation by BTC
At any time prior to the Program start date, BTC 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, trip fees paid to BTC by Volunteer for that program may be refunded. Notwithstanding the above, no such refund shall be made in the event of a cancellation by BTC due to any extraordinary event or circumstance beyond the control of BTC, such as a war, strike, riot, act of terrorism, or an event described by the legal term "Act of God" (such as hurricane, flooding, earthquake, volcanic eruption, etc.), beyond the control of BTC that, in the sole opinion of BTC, renders travel or participation in a Program unsafe or impracticable. In those and all other circumstances, BTC shall not be responsible to Volunteer for any other refund, costs, interest, liability, losses, or damages of any kind, including airfare.Withdrawal by Volunteer
If Volunteer withdraws for any reason, Volunteer must notify BTC in writing. Such withdrawal will not be effective until received in writing by BTC at its offices at the address set forth below. BTC incurs substantial administrative and planning costs with respect to each Program. Therefore, if Volunteer voluntarily withdraws from the Program, funds paid by Volunteer to BTC will be refunded only as set forth below:
* The $250 deposit will not be refunded. Volunteer may, however, apply the deposit to another BTC program scheduled to take place within twelve(12) months of the original Program start date, subject to space availability.
* If the withdrawal is effective thirty (30) days or more prior to the Program start date, the balance of the program fee paid, not including the $250 deposit, will be refunded to Volunteer.
* If the withdrawal is effective less than thirty (30) days prior to the Program start date, no trip fees paid will be refunded; however, Volunteer may still transfer those fees to another Volunteer in a BTC Program, or towards the trip fee of another trip by Volunteer within twelve (12) months of the original Program start date.
* No portion of any Program Fee paid shall be refunded if the withdrawal is received on or after the Program start date. Furthermore, no refunds will be made for unused portions of the Program or because of Volunteer's withdrawal or removal from the Program for any reason after the Program start date.
* Changes to and cancellation of airfares are subject to the regulations of the providers, and any travel fees, charges, expenses or penalties that might result from any cancellation of or withdrawal from the Program will be the sole responsibility of the Volunteer.Alterations to Program
BTC 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. BTC 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, 3) any costs incurred should Volunteer be injured, become sick, or otherwise require a doctor’s visit or hospitalization, or 4) withdraw early from or remain past the time scheduled for the Program.
BTC is not responsible for the acts or failures to act of anyone who provides goods or services in connection with the Program. In addition, BTC is not responsible for any costs, losses, damages, interest, 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
BTC has the authority at any time and in its sole discretion to dismiss Volunteer from the Program. Causes for dismissal may include, but are not limited to:
* Behavior that is destructive, abusive, violent, or involves harassment, theft, vandalism, or chronic defiance of policies.
* Refusal to abide by the laws and regulations of the country and local community or of the United States of America and /or the State of New York, or to behave in a manner that is appropriate therein, all as determined by BTC in its sole discretion.
* Engaging in inappropriate sexual activity, unauthorized absence from the group, or failure to abide by curfews and/or other set policies or expectations.
* Possession or use of any weapons, non-prescribed drugs, or narcotics.
* Deterioration of Volunteer's physical health or mental condition.
BTC personnel may discuss Volunteer's situation, including Volunteer's health, physical, or mental condition, with any person, including other BTC personnel, family members, or medical personnel, and release any information concerning Volunteer to such person. If Volunteer is dismissed from the Program, BTC 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 non-refundable.Personal Property Loss
BTC takes all reasonable measures to ensure the security of Volunteer's personal belongings. However, petty theft occurs worldwide. BTC will not be held responsible for the loss of, theft of, or damage to, Volunteer's personal property or equipment.
BTC 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 on the Program.Medical Insurance and Emergency Treatment
BTC will provide emergency medical evacuation insurance to all Volunteers and maintain employer's liability insurance for any claims by Volunteers as part of the Program Fee. Volunteer acknowledges that all information that Volunteer has supplied to BTC concerning his or her medical condition and physical and mental health is accurate and complete. Volunteer acknowledges that he or she has reviewed the emergency medical evacuation insurance coverage (provided upon request) and is aware of the coverage limits of that insurance. Volunteers should check with their medical insurance carrier and be aware of the limits of their own medical coverage while traveling internationally. Volunteers should make arrangements to provide additional or supplemental insurance to provide for such coverage, in the case where medical services are required.
Should any medical emergency arise which precludes Volunteer's ability to consent to emergency treatment, BTC will endeavor to communicate with the person designated by Volunteer to request permission for any necessary treatment. If BTC personnel believe, in their sole discretion, that time or circumstances do not permit such communication, Volunteer authorizes BTC 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 BTC 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 BTC presentations or publications. Volunteer agrees that, in connection with such use, BTC, and persons acting for or on behalf of BTC, may identify Volunteer by name, age, city and/or state or country of residence.
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 sanitation, work site injury, waterborne infections and diseases, insect and animal bites, and travel by air, automobile, truck, on foot or by other conveyance.
As stated in the health information section, Volunteers must provide complete and current health information, and are strongly advised to consult a medical doctor for information about immunizations, your physical preparedness to undertake strenuous work activities at one of the work sites, and any medications that may be necessary. Volunteer assumes all the risks of the Program, including health and personal safety risks, and waives all claims for loss or injury to person or property while participating in any of the activities contemplated thereby, whether such damage, loss, or injury results from the negligence of BTC or its officers, directors, representatives, employees, liability insurance carriers or agents, or from any other cause.
Therefore, in consideration of the right to participate in the Program, and of the services, food and transportation arranged by BTC, and its agents and associates, the undersigned Volunteer, intending to be legally bound, consents to the assumption of such risks, and agrees to forever waive, discharge and release for Volunteer and Volunteer's heirs, executors, and administrators, all rights and claims for injuries, damages, illness, losses, demands and other actions of every kind and nature whatsoever, which Volunteer may have against BTC or its officers, directors, employees, liability insurance carriers and agents and all of those entities' representatives, successors and assigns, resulting from or in connection with the Program or any other activities arranged for Volunteer by BTC and/or its agents and associates.