DMI Mission Trip Sign Up Form

Mission Trip Sign Up Form
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of your organization
Name of your sponsors ,if any
Why do you want to be a part of this mission trip?
Purpose Of The Mission Trip
Skills or Experience Relevant to the Mission Trip
Church Affiliation
I hereby agree to participate in the Deborah Ministries Mission Trip to Nigeria, and acknowledge that certain risks and dangers are associated with this activity. I acknowledge that these risks include, but are not limited to, injury, illness, and death, as well as loss or damage to personal property.In consideration of being permitted to participate in this activity, I agree to assume full responsibility for any risks, injuries, or damages that I may sustain, or that my property may sustain, as a result of my participation in this activity. I agree to release, waive, discharge, and hold harmless Organization Name , its officers, directors, employees, and agents, from any claims, damages, or liabilities that may arise out of or in connection with my participation in this activity.I further agree to indemnify and hold harmless , its officers, directors, employees, and agents, from any claims, damages, or liabilities that may arise out of or in connection with my participation in this activity, including but not limited to, claims made by third parties.I understand that this Liability Waiver and Release Agreement is a binding legal agreement, and I sign it voluntarily and with full knowledge of its contents. I acknowledge that I have read and fully understand the terms and conditions outlined in this agreement.
Date

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Date
Signature

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