GSM Release Form

Team Member Information & Release Form

This form must be completely filled out, signed and returned with a copy of the photo page of your passport before we can guarantee a trip price and purchase your tickets. If you have applied for your passport but have not yet received it please enter the date you submitted your application here:

Name as shown on passport

Gender

Date of Birth

Date

Trip Dates

Date

Address

City

State

Zip

Work Phone

Cell Phone

Email

example@example.com

Airport Code

Shirt Size

Spouse Name (if applicable)

Emergency Contact name, relationship and phone numbers

Allergies or Medical Conditions

IMPORTANT NOTICE - Please read carefully! Due to IRS regulations we cannot give refunds for any reason. By signing this form you are agreeing that you will not be refunded any money for any reason. You are also agreeing to pay the full trip price without exception once the airfares are purchased. If you are concerned that you may not be ableto make your trip you should purchase trip cancellation insurance. I understand that this trip includes risks of personal injury and accept personal responsibility for these risk S to myself. I release Get Strong Ministries, Inc. and all of their representatives from liability for any loss or injury that may occur in connection with this trip. Get Strong Ministries, Inc. is a is a 501(c)3 non-profit organization. All donations are tax-deductible as allowed by the IRS regulations and are made with the understanding that Get Strong Ministries, Inc. has complete control and administration over the use of the donated funds. However, we strive to honor all preferences you may have as to how your donation is used.

Signed

Clear

Date

If team member is a minor parent or guardian must sign here

Clear

Get Strong Ministries, Inc., 136 Clearview Circle, Hendersonville, TN 37075 cbatson@getstrongministries.com