Harm & Release Form

In consideration of my acceptance as a short-term volunteer with Productive Lives I represent and agree that:

1. I am aware of the hazards and risks to my person and property associated with serving in a missions capacity, such hazards and risks including, but not being limited to, death or injury by accident, disease, war, terrorists acts, weather, conditions, inadequate medical services and supplies, criminal activity, and random acts of violence. I accept my assignment with full awareness of these risks, and subject to the insurance coverages described below, I voluntarily assume all risks of death, injury, illness, and damage to myself or any member of my family associated with such risks, and any damage to my personal property. I further recognize that such risks have always been associated with missionary service.

2. I attest and certify that I have no medical conditions that would prevent me from performing my duties.

3. Subject to insurance coverages provided, I release and hold harmlessProductive Lives and their officers, board members, employees, agents, contractors and representatives from any and all losses, expenses, damages, demands, and claims arising out of, or in connection with my decision to serve as a short-term missionary and the acts and omissions related to my short-term missions trip (collectively “Loss”).

4. In the event that I have minor children who will accompany me on my assignment, I, acting both on my own behalf and in their behalf as their parent and legal guardian, and subject to the insurance coverages described below, do hereby assume all risks of Loss.

5. I expressly waive any defense to the enforcement of any provision of this commitment arising from a claim of lack of consideration and warrant that this commitment constitutes a legal, valid, and binding obligation upon me enforceable against me in accordance with its terms.

6. I expressly agree that this Release and Hold Harmless Agreement is intended to be as broad and inclusive as permitted by law. I further state that I HAVE CAREFULLY READ THE FOREGOING ASSUMPTION OF RISK AND UNDERSTAND ITS CONTENTS;AND I VOLUNTARILY SIGN THIS RELEASE AS MY OWN FREE ACT.

7. I feel that God is leading me to be a part of this mission trip. I have spent time praying about this opportunity and feel that God is leading me to be a part of this team. I also confirm that my answers are truthful and accurate.