Release from Liability RELEASE FROM LIABILITY AND COVENANT NOT TO SUE HEALING THE CHILDREN NORTHEAST INC. A CONNECTICUT BASED NON PROFIT CORPORATION AND OTHERS THIS IS A RELEASE AND LIMITATION OF YOUR RIGHT TO SUE. PLEASE READ IT CAREFULLY AND UNDERSTAND IT BEFORE CHECKING THE AGREEMENT BOX! I, as a member of Healing the Children Northeast understand that this is a legally binding Release and Covenant Not to Sue Healing the Children Northeast, its board members, trustees, directors, principals, officers, employees, legal representative, contractors, agents and assigns (collectively referred to hereafter as “HTCNE”) for any and all liability caused directly or indirectly by my travel and participation in HTCNE’s medical missions, including any claims resulting from or arising out of negligence attributable to HTCNE. I am volunteering to participate in a medical mission trip and understand that HTCNE does not require me to participate in this mission, but I want to do so despite the possible dangers and risks I may encounter and despite the Release and Covenant Not to Sue. I fully recognize that there are dangers and risks to which I may be exposed and that I could encounter by participating in this mission, including but not limited to travel accidents or delays, crime or violence, infectious diseases, and limited access to medical treatment or resources. Additionally, I have read the Country Specific Information published by the U.S. Department of State on its website: https://travel.state.gov/content/travel/en.html AND the Center for Disease Control (CDC) website: https://wwwnc.cdc.gov/travel/destinations/list/ where I can fill in the destination for this mission. I acknowledge the risks to travelers identified by the State Department and any applicable travel warnings for this destination. I understand that HTCNE (including any team leaders and individuals in our group) may not be able to intervene or rescue me if I become involved in acts of crime or violence. I also understand that medical care and medical facilities might not be readily available and that they probably will not meet the standards expected in the United States. To the best of my knowledge my health is good enough to undertake this mission. If I have a question about my health, I will visit my physician and discuss this trip before I go. I understand that I will be traveling to places where little to no health care will be available. In addition, I understand that I may undergo types of exertion that I am not used to. I fully recognize that I may encounter these or other health and / or safety risks as a result of my decision to participate in this mission. I agree that it shall be my responsibility to maintain a current knowledge of travel advisories, medical advisories or other risks until my departure and while I am on location. It shall be my responsibility to notify HTCNE if I learn anything that would alter the risks to me or to others at any time. I hereby agree to assume and take on myself of all the risks and responsibilities in any way arising from, or associated with, my participation in this mission. I hereby release HTCNE from any and all claims, demands, suits, judgments, damages, actions, and liabilities of every name and nature whatsoever, whenever occurring, whether know or unknown, contingent or fixed, at law or in equity, that I may suffer at any time arising from or in connection with this mission, including any injury or harm to me, my death, emotional distress, or damage or loss of my property, lost time, lost wages, costs or expenses of any kind (including medical), and I agree to defend, indemnify and hold HTCNE harmless from and against any and all of these liabilities, including any claims resulting from or arising out of negligence attributable to HTCNE. I recognize that this Release and Covenant Not to Sue means that I am giving up, among other things, all rights to sue HTCNE for injuries, damages or losses I may incur. I also affirm that I have adequate medical or health insurance to cover any medical assistance I may require. I agree that this Release and Covenant Not to Sue shall be governed by Connecticut Law and that any action regarding my participation in this mission, or this Release and Covenant Not to Sue, shall be brought in the federal or state courts of Connecticut. If any portion of this Release and Covenant Not to Sue shall be deemed by a Court of competent jurisdiction to be invalid, then the remainder shall remain in full force and effect and only the offending provision or provisions severed. ***Please be sure to sign and date the bottom of this Registration Form. Medical Missions Statement of Behavior While in Host Country This statement is intended as a guide to our teams. We have no interest in dictating the behavior of our valuable volunteers. However, the adventure of a new and foreign place, the hard work you will do, and the need to unwind can sometimes cause us to forget our responsibilities. Each of you represents Healing the Children Northeast, the United States, or your own country of origin and you should do so with pride. The hard work and reputation of others precedes you and because of this you will be held in high regard. Help us to build on that reputation. You will be a guest in this country where traveling. Your hosts will be grateful for your presence and will work hard for your safety and well-being. Please respect their efforts by not abusing alcohol, behaving inappropriately or putting yourself or your team in danger. Do not wander off alone or take unnecessary risks. Keep reasonable hours and plan to arrive at the hospital on time. Remember that nursing and hospital staff, many of whom, may be volunteers, will be waiting for you. Please dress appropriately and do not wear your scrubs outside of the hospital. Please follow the same practices that we practice here in the United States. Those who do not respect these guidelines may not be reprimanded at the time but will most likely NOT be asked to travel again. We are grateful for the gift of your time on behalf of the world’s needy children and wish you a successful trip. Fondly,The Staff and Board of Directors of Healing the Children Northeast I have read the above Release from Liability and Medical Missions Statement of Behavior.