Brigade Participant Waiver Form - Change for Children

Brigade Participant Waiver Form

Activities of the brigade will include transport within the host country, visits to remote communities, and participation in health clinics. Please read and accept the following.*

Terms & Conditions*

I understand that during the duration of the activities, I may encounter various risks to my health and safety that could result in death, injury or damage to my personal property, due to factors related but not limited to: variations in climate, natural disasters, water-borne illnesses, malaria, political instability, transportation and variations in diet.

I understand that during the duration of the activities, I may encounter various risks to my health and safety that could result in death, injury or damage to my personal property, due to factors related but not limited to: variations in climate, natural disasters, water-borne illnesses, malaria, political instability, transportation and variations in diet.

I understand that during the duration of the activities, I may encounter various risks to my health and safety that could result in death, injury or damage to my personal property, due to factors related but not limited to: variations in climate, natural disasters, water-borne illnesses, malaria, political instability, transportation and variations in diet.

First Name*

Please provide your legal first name

First Name*

Please provide your legal last name

Date*

Participating in Brigade to:*