waiver-2 – Vision Outreach International

U. S. State Department THREAT LEVEL #4 WAIVER

All mission team members that want to participate in a mission trip where the US State Department has classified it as LEVEL 4 THREAT MUST FILL OUT AND SIGN this additional Waiver in the presence of a WITNESS before being approved for the Mission Trip in question.

Name of Country of Your Trip (year and month) *

Today's Date *

BELOW - click on the link "US STATE DEPARTMENT TRAVEL ADVISORY" and type in the country name of your trip to get the latest updates.

Check all that you have completed (ALL are required) *

(1) I understand and have read the US STATE DEPARTMENT TRAVEL ADVISORY concerning my mission trip.
(2) I have had adequate time to process this information with my family and friends.
(3) I understand the risk of possible sickness, injury, kidnapping, or demise.
(4) If I am kidnapped, I fully understand that VOI and associates will not pay a ransom.
(5) I have check with my personal insurance company to make sure my health, disability, and life insurance are not at risk due to my participation.

AS A RESULT OF THE ABOVE SELECT ONE OF THE TWO OPTIONS *

I have decided TO CONTINUE to participate in this endeavor as a volunteer and release the Vision Outreach International board, staff, trip leadership, international host/hostess, or anyone associated with them from the responsibility of harm incurred from this new threat level. I am participating as a volunteer, on my own accord, without coercion from others.
I have decided to respectfully DECLINE THIS OPPORTUNITY to participate because of the heightened THREAT LEVEL and the information I have discovered in my research.

Your Printed Name *

Signature *

Your Witness Printed Name *

Signature *

I have WITNESSED the SIGNING of this Document and understand the concerns listed above. I AM NOT PARTICIPATING in the mission endeavor listed above!