MEDIA RELEASE AND CONSENT

I hereby give Certain Place Ministries, Inc. (“CPM”) together with the "Work Week Group”, and their licensees, including organizers and sponsors of events in which the Work Week Group participate, the right to photograph, film, record, document or capture, my name, image, voice, statements, and likeness (collectively "Likeness").  I further consent to the use, reuse, reproduction, license, display, and publication of such Likeness without restriction, in any and all media now known or hereafter devised throughout the universe in perpetuity for any purpose whatsoever in connection with the promotion of CPM, the Church, and Guatemala work weeks and their licensees, including without limitation any commercial or noncommercial use on websites, social media, news or advertising.  I understand that my Likeness may be combined with other images, videos, text, and/or graphics and may be cropped, altered, or modified. I hereby hold the Work Week Group and their licensees harmless and forever waive and release any claims against the Work Week Group and their licensees based on any rights of privacy, publicity, defamation, copyright infringement, or any other right that may arise from or be related to the use, exhibition, license, modification, distribution, publication, or reproduction of my Likeness. I understand that no compensation will be provided to me for or in connection with any use of my Likeness.  I represent and warrant that I am at least 18 years of age and able to provide this consent.

Activity/Event: The Guatemala Help Week (the “Activity”)

Date of Activity/Event: May 17-24, 2026

Location of Activity/Event: Antigua, Guatemla and the surrounding villages

Transportation:  I understand and acknowledge that transportation (including air travel) arrangements to and from Antigua Guatemala are my responsibility whether I travel in my own personal vehicle or with another individual(s). I additionally understand and acknowledge that in the event that I travel in my own personal vehicle or with another individual, I agree that I am responsible for my own acts and for the safety and security of my own vehicle.  I accept full responsibility for the liability of myself and my passengers, and I understand that if I am a passenger in a private vehicle, Certain Place Ministries, Inc. is not in any way responsible for the safety of such transportation.  I further agree that Certain Place Ministries' insurance does not cover any damage or injury suffered in the course of traveling in a private vehicle.

Assumption of Risks: I understand that participation in this Activity carries with it certain risks and hazards directly or inherently involved that cannot be eliminated regardless of the care taken to avoid injuries: The risks include but are not limited to: 1) minor injuries such as scratches, bruises, and sprains; and 2) major injuries such as joint or back injuries, broken bones, head injuries, severe physical trauma, heart attack and stroke; or 3) other potential risks of loss of limb, property or life.  I also understand and recognize that there are risks and hazards directly or inherently involved in travel to and from this Activity and while participating in this Activity, and I expressly assume those risks.  With full knowledge of the facts and circumstances surrounding this Activity, I voluntarily undertake this Activity and assume all responsibility and risk associated with my participation in this Activity, including all risk of injury, property damage, injury to others, and other hazards to me. 

Waiver: In consideration of my voluntary participation in this Activity/Event and whether or not I travel to and from this Activity in my own personal vehicle, or whether I travel with another individual(s), I for myself, my heirs, personal representatives or assigns, do hereby release, waive, discharge, and agree to hold harmless CERTAIN PLACE MINISTRIES, INC.; its trustees, officers, agents, employees, volunteers and those for whom CERTAIN PLACE MINISTRIES may be held responsible, from any and all claims of liability for personal injury, accident, illness or death, and property loss arising from my participation in this Activity.  I willingly participate in this Activity and I assume any and all associated risks.

Assurances:  I assure officials of Certain Place Ministries, Inc. that I have adequate health insurance necessary to provide for and pay any medical costs that may directly or indirectly result from my participation in this Activity.   I further assure that there are no health-related reasons which preclude or restrict my participation.

Code of Conduct: I acknowledge that during the course of this trip, I am bound by the rules contained in the Guatemala Help Week list of rules and by any compliance form issued by my faith community.

INDEMNIFICATION:  I AGREE TO INDEMNIFY AND HOLD HARMLESS CERTAIN PLACE MINISTRIES, INC., ITS  TRUSTEES, OFFICERS, DIRECTORS, AGENTS, EMPLOYEES, VOLUNTEERS AND THOSE FOR WHOM THE CERTAIN PLACE MINISTRIES MAY BE HELD RESPONSIBLE FROM AND AGAINST ALL CLAIMS, ACTIONS, SUITS, PROCEDURES, COSTS, EXPENSES, DAMAGES AND LIABILITIES, INCLUDING ATTORNEY’S FEES BROUGHT AS A RESULT OF MY INVOLVEMENT AND PARTICIPATION IN THIS ACTIVITY  INCLUDING BUT NOT LIMITED TO, ANY DAMAGE TO MY PROPERTY OR THE PROPERTY OF OTHERS AND INJURY TO ME OR TO OTHERS, INCLUDING LOSS OF LIMB OR LIFE, ARISING OUT OF MY PARTICIPATION IN THIS ACTIVITY.

Severability: The undersigned further expressly agrees that the foregoing waiver and assumption of risks agreement is intended to be as broad and inclusive as is permitted by the laws of the state of Arizona and the nation of Guatemala and that if any portion of it is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

Acknowledgement of Understanding:  I have read this waiver of liability, assumption of risk, release and indemnity agreement, fully understand its terms, and understand that I am assuming all risks associated with this Activity/Event and giving up substantial rights.  I recognize that this Release means that I am giving up the right to sue CERTAIN PLACE MINISTRIES, INC., its trustees, officers, agents, employees, volunteers, and those for whom CERTAIN PLACE MINISTRIES may be held responsible, for injuries or losses I may incur, and I understand this Release binds my heirs, executors, administrators and assigns, as well as me.  I acknowledge that I am at least 18 years of age and am signing this document freely and voluntarily and intend by my signature to completely and unconditionally release the above-named parties of all liability to the greatest extent allowed by law.

Adult Registration Fee:

$600 per person 
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The registration fee for the aformentioned $600 comes with the expectation and goal that each individual volunteer raise at least an additional $600 apiece toward the cause (which can be done both individially and through the faith community).

Your registration will not be accepted until we receive your registration fee.  You will receive an email with a link to the online Registration fee payment page once this registration is submitted.  Or you can use the link provided on the Guatemala Registration page from the main website.

All volunteers must be in full compliance with Casa or Diocesan Safe Environment Guidlines in order to participate in the Guatemala Help Weeks.

In order to ensure that we are in a safe environment, we require that you comply with your diocese's or organizations's safe environment compliance procedures before you are allowed to volunteer with us.  Once you submit this form, you will be emialed instructions on compliance procedures.  The 3 required steps are:

·         Complete an online background check

·         Read, understand and acknowledge a Pastoral Code of Conduct

·         Complete on online training

If you have already done these three things, you do not need to do anything else other than finish this form, submit it and pay the registration fee!

If you have not done these things, you must complete by April 1, 2026.   Instructions will be sent to you via email upon completion of this registration.