Application for NC Disaster Relief Trip

NC Disaster Relief Application

October 14-17, 2026
We will be traveling to Marion, NC to help Baptists on Mission as they continue to help residents rebuild from the devestating effects of Hurricane Helene. This trip will require phyiscal work, good attitudes, and a desire to serve in Jesus' name. You will be notified within 2 days if you are on the team, at which point, you will need to pay the non-refundable $25 cost for the trip to secure your place. You will be expected to attend a team meeting on Monday, October 5 at 10:10. If you have questions, please email me at jhanson@andersonuniversity.edu.

There is a waitlist right now, but we are asking if we can increase our group size. Go ahead and fill out the form, and we will let you know as soon as possible.
Name

First NameLast Name
Phone Number
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Email
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Emergency Contact - Name, relationship, and phone number
Any dietary restrictions/allergies? If so, please specify.
Any physical limitations? If so, please describe.
Any mental or emotional challenges? If so, please describe.
Release and Liability Waiver

Initial all blanks except the last one. Sign the last one. IF THE PARTICIPANT IS OVER 18 YEARS OF AGE, THE PARTICIPANT MUST AGREE TO AND INITIAL THE FOLLOWING CLAUSES, AND THEN SIGN BELOW. IF THE PARTICIPANT IS UNDER 18 YEARS OF AGE, A PARENT OR LEGAL GUARDIAN MUST COMPLETE AS ABOVE.CAUTION: READ BEFORE SIGNING. THIS IS A RELEASE AND LIABILITY WAIVERIN CONSIDERATION OF BEING PERMITTED TO VOLUNTARILY PARTICIPATE IN ANY WAY IN THE ABOVE-DESCRIBED ACTIVITY (HEREINAFTER CALLED THE “ACTIVITY”) AND USE CERTAIN FACILITIES AND PROPERTY OF ANDERSON UNIVERSITY IN RELATION TO THE ACTIVITY, INCLUDING, WITHOUT LIMITATION, CERTAIN PROPERTY, FIELDS, BUILDINGS, RESIDENCE HALLS AND EQUIPMENT (COLLECTIVELY TERMED HEREIN “FACILITIES”), I, FOR MYSELF (AND/OR MY MINOR CHILD), THE HEIRS, PERSONAL REPRESENTATIVES AND ASSIGNS OF THE UNDERSIGNED, DO HEREBY COVENANT NOT TO SUE ANDERSON UNIVERSITY, THE BOARD OF TRUSTEES OF ANDERSON UNIVERSITY (COLLECTIVELY, HEREAFTER CALLED THE “UNIVERSITY”), ITS OFFICERS, EMPLOYEES, AND AGENTS, AND I DO HEREBY RELEASE, WAIVE, AND DISCHARGE FROM LIABILITY THE UNIVERSITY, ITS OFFICERS, EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS, INCLUDING THE CLAIMS ARISING FROM THE NEGLIGENCE OF THE UNIVERSITY, ITS OFFICERS, EMPLOYEES AND AGENTS, RESULTING IN PERSONAL OR EMOTIONAL INJURY, ILLNESS, PHYSICAL DISABILITY, DEATH, PROPERTY LOSS, AND DAMAGES ARISING FROM, BUT NOT LIMITED TO, PARTICIPATION IN THE ACTIVITY OR USE OF THE FACILITIES.
(1) I acknowledge that participation in the Activity is completely voluntary and is not required or mandated by the University.
(2) I acknowledge that through participation in the Activity, there is a risk of personal and emotional injury, property loss, illness, physical disability, and death. I further acknowledge that the specific risks vary from one activity to another, but the risks range from (a) minor injuries such as scratches, bruises, and sprains (b) major injuries such as burns, eye injury or loss of sight, joint or back injuries, heart attack, and concussions, to (c) catastrophic injuries including paralysis, permanent disability, and death. The risk of injury from the Activity is significant. I further acknowledge that while precautions and personal discipline will minimize these risks, the risk of personal and emotional injury, property loss, illness, physical disability, or death is inherent to the Activity, use of the Facilities, or travel.
(3) I agree and acknowledge that participation in the Activity is with full and complete knowledge of the risks and dangers involved, and I agree to accept and assume all risks of any nature whatsoever, including those which may lead to personal injury, emotional injury, property loss, illness, physical disability, or death.
(4) If any illness or injury is suffered in any way connected to participation in the Activity, if possible, I will immediately notify the University.
(5) I understand and acknowledge that an emergency may develop which necessitates the administration of medical care. In the event of injury or illness, I authorize the University to secure appropriate treatment including the transportation, hospitalization, and administration of an anesthetic and surgery. I understand that such treatment shall be solely at my expense. Notwithstanding this paragraph, I understand and agree that the University has no obligation to provide or seek out any medical treatment for a participant.
(6) I understand and acknowledge that it is participant’s responsibility not to exceed any guidelines that participant’s health care provider has established or may establish. I understand and acknowledge that it is solely participant’s responsibility to determine through consultation with their health care provider what their physical limitations are or may be and whether participant should or should not participate in the Activity or use the Facilities. I acknowledge that by participating in the Activities I am certifying that participant is physically and mentally able to do so and assume all risks associated with the Activity.
(7) I have been informed and I fully understand that any information given to me by anyone on behalf of the University regarding any illness or injury is intended to be used in participant’s sole discretion and for informational purposes only, especially if participant has allergies, takes any medications, or is being treated for any illness or condition. Such information is not medical advice, and I understand that I am encouraged to consult participant’s own health care provider before using any such information. Should I decide to use all or any part of such information, this decision shall be entirely at my own risk.
(8) I understand this voluntary release, discharge, and agreement to indemnify the University applies to the above activity with all modes of university transportation or any other type of transportation (transit, van, bus, etc.) should I so choose. Further, this voluntary discharge and indemnification of the University shall apply to the driving of my personal vehicle or being the passenger in a personal vehicle of another individual, should I so choose.
(9) I acknowledge and agree that the parties I am forever discharging and releasing by and through this Agreement are as follows: the University, its officers, employees, and agents (collectively, the "Released Parties").
(10) I FOR MYSELF (AND/OR MY MINOR CHILD) VOLUNTARILY RELEASE, FOREVER DISCHARGE, AND AGREE TO INDEMNIFY AND HOLD THE RELEASED PARTIES HARMLESS FROM ALL LIABILITIES, CLAIMS, DEMANDS, CAUSES OF ACTION, DAMAGES, COSTS (INCLUDING ATTORNEY’S FEES), EXPENSES AND OBLIGATIONS OF ANY NATURE WHATSOEVER FOR ANY INJURIES, ILLNESSES, DISABILITIES, OR DEATH THAT PARTICIPANT MAY SUSTAIN AS A RESULT OF, OR IN ANY WAY CONNECTED TO PARTICIPANT’S PARTICIPATION IN THE ACTIVITY, USE OF THE FACILITIES, OR TRAVEL.
(11) I, FOR MYSELF (AND/OR MY MINOR CHILD) AND FOR THE HEIRS, PERSONAL REPRESENTATIVES, EXECUTORS, ADMINISTRATORS AND ANYONE ELSE WHO MIGHT MAKE A CLAIM ON MY BEHALF, AGREE NOT TO MAKE ANY CLAIM OR COMMENCE OR PROSECUTE ANY ACTION, SUIT OR OTHER PROCEEDING AGAINST ANY OF THE RELEASED PARTIES FOR ANY PERSONAL INJURY, EMOTIONAL INJURY, PROPERTY LOSS, ILLNESS, DISABILITY OR DEATH, WHETHER CAUSED BY THE RELEASED PARTIES OR OTHERWISE, SPECIFICALLY INCLUDING, WITHOUT LIMITATION, ANY PERSONAL INJURY, EMOTIONAL INJURY, PROPERTY LOSS, ILLNESS, DISABILITY OR DEATH CAUSED BY OR A RESULT OF STRICT LIABILITY, OR THE NEGLIGENCE OR GROSS NEGLIGENCE OF THE RELEASED PARTIES RESULTING FROM PARTICIPATION IN THE ACTIVITIES, USE OF THE FACILITIES, OR TRAVEL.
(12) I agree that this Agreement shall be construed and enforced in accordance with the law of the State of South Carolina, and I hereby consent to the jurisdiction of South Carolina.
(13) I agree that if any portion of this Agreement is declared invalid or unenforceable, the remaining portions of this Agreement shall remain in full force and effect.
(14) I agree that if participant intentionally, negligently, or recklessly cause any damage to the Facilities, I agree to fully reimburse Anderson University for all of said damages.
(15) I UNDERSTAND AND AGREE THAT THIS DOCUMENT WILL BE USED AS A DEFENSE BY THE PARTIES TO ANY AND ALL CLAIMS RESULTING FROM PARTICIPATION IN THE ACTIVITY BROUGHT BY ME (AND/OR MY MINOR CHILD), THE HEIRS, PERSONAL REPRESENTATIVES, EXECUTORS, ADMINISTRATORS AND ANYONE ELSE WHO MIGHT MAKE A CLAIM ON MY BEHALF. I UNDERSTAND AND AGREE THAT THIS AGREEMENT AND THE RELEASE AND LIABILITY WAIVER CONTAINED HEREIN IS A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND INTENDED TO PROTECT THE RELEASED PARTIES TO THE FULLEST EXTENT POSSIBLE.
I VERIFY THAT I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THIS AGREEMENT AND THAT I ACCEPT THIS AGREEMENT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE OR GUARANTEE BEING MADE TO ME. I UNDERSTAND THE TERMS OF THIS AGREEMENT, AND I UNDERSTAND THAT I AM GIVING UP SUBSTANTIAL RIGHTS BY ACCEPTING IT, INCLUDING MY RIGHT TO SUE.
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NC Disaster Relief Application

Release and Liability Waiver