Acknowledgement and Release for Alliance for Smiles mission to Sagaing, Myanmar from March 21 to April 4, 2020
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I have voluntarily agreed to participate in an international surgical trip (the “program”) sponsored by Alliance for Smiles, Inc (AfS). I acknowledge that there may be significant potential dangers and risks as a result of the occurrence of events during my participation in the program which might cause personal injury or sickness, death or damage to my own property.
I agree to participate in the program at my own risk, and assume all risks of any kind associated with such participation. I have done any research on the host country that I feel is necessary to allow me to make an informed decision to take part in the program. I understand that on a typical Alliance for Smiles medical mission any of the following may be true:
* Long working hours may be required: at least 10 hours per day, six days per week, with few breaks.
* There is limited climate control.
* Some lifting is required.
* AfS relies on local hosts to provide food and may not have control over the quality of the menu.
* Accommodations are basic with at least two persons to a room. If private rooms are available, a request can be made for a private room but the volunteer will have to pay the additional costs.
* Beds in foreign countries may be very hard.
* Access to prescription drugs may not be available.
* Emergency medical care may not be available for some ailments.
* There is a potential for exposure to blood borne pathogens.
In consideration of AfS’ sponsorship of the program, and its decision to allow me to participate, by clicking SUBMIT below, I hereby waive, release and forever discharge AfS and its employees, agents, directors, sponsors, promoters, and volunteers from any and all liability, claim, damage, loss cost or expense arising from or attributable in any way to any of the events enumerated in the preceding paragraph or any action, omission to act or negligence of any such person or organization in connection with the sponsorship, organization or performance of services associated with the trip, including related travel.
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