(NOTE: please include if date is available on the website, if training dates are full, type “waiting list” in the box)

(NOTE: please include if date is available on the website, if training dates are full, type “waiting list” in the box)

By typing your FULL NAME in the SIGNATURE BOX, you agree to the following:

I release Vision Outreach International (VOI) , its officers, trip organizers and leaders, members and team associates from responsibility for any accident, injury, sickness or death to me or any member of my family and/or loss of material items occurring as a result of any mission or training expedition. I understand and accept the personal health and safety risks involved.

I will be a guest of the host country and subject to the local laws and customs and to the policies of Vision Outreach International.

I will be working under and subject to the authority of the training Ophthalmologist or Project Director and agree to abide by his or her directives while visiting and working in the host country. I will be personally responsible for my transportation expenses, lodging, meals, and any other incidental expenses. I understand that should it be necessary for me to cancel my participation, any refunds of airfare or other prepaid services will be my responsibility.

I further give Vision Outreach International officers, expedition leaders, and other designated personnel my authorization to release pictures or stories about my participation in an expedition or training to the media.

I have read, understand and agree to the condition of this waiver, and do affirm that I am the person whose name appears below.

I realize that TYPING my name in the SIGNATURE BOX affirms that I have filled out this application with valid and correct information and agree to abide by its contents