Trip(s) you are applying for *

(You may select more than one. Dates are subject to change)

Kenya medical - June 18th-29th

Ethiopia - July 1st-9th

Egypt - September 2024

Other future trips

Name *

First Name

Last Name

Birthdate *

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DD

YYYY

Phone *

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Passport expiration date *

Please note that your passport must not be due to expire within 6 months of trip return date.

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DD

YYYY

Policy Holder's Birthdate: *

MM

DD

YYYY

Physician's Phone:

(###)

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Terms, Release and Waiver of Liability *

I recognize that there are risks involved in participating in any TOLI Trip and hereby assume all risk of injury, harm, damage, or death in connection with my participation in it. I understand and agree that neither Touch of Love International (TOLI) nor its trustees, officers, directors, employees, agents or representatives may be held liable in any way for any injury, harm, damage, or death that may occur to me as a result of my participation in this trip and hereby release TOLI, its trustees, officers, directors, employees, agents and representatives from any injury, harm, damage or death, which may occur while I am participating in the trip. To the fullest extent permitted by law, I agree to save and hold harmless TOLI, its trustees, officers, directors, employees, agents and representatives from any claim by myself, my estate, heirs, successors, assigns or other persons arising out of my participation in the trip.

I authorize TOLI through its trustees, officers, directors, employees, agents or representatives to render or obtain such emergency medical care or treatment for me as may be necessary should any injury, harm or accident occur to me while participating in the mission trip.

COVID-19 DISCLAIMER AND RELEASE. Before we make or finalize arrangements for your trip, we require that you confirm that you read and agree by signing below. Your signature or click will signify your agreement with the following terms and conditions: 1. HEALTH AND OTHER HAZARDS: You agree that it is your personal decision to travel, and you are doing so with full knowledge of current travel recommendations and travel restrictions with regards to the risks of COVID-19. We assume no responsibility for and shall not be liable for unsafe conditions or health hazards including pandemics or other illnesses. We have no special knowledge of dangers during travel or at destinations. For information related to such dangers, we recommend going to the State Department travel website at www.travel.state.gov. For medical and health information, we recommend going to the Centers for Disease Control website at www.cdc.gov/travel. 2. VACCINATION REQUIREMENTS AND OTHER RULES: We have no responsibility for COVID-19-related requirements that travel suppliers and governments may impose from time to time, such as required vaccinations, health affidavit forms, COVID-19 screenings prior to departure or upon arrival, face coverings, or quarantines. For the latest COVID-19 government travel regulations, we recommend going to IATA’s website at https://www.iatatravelcentre.com/international-travel-document-news/1580226297.htm. For the latest travel supplier requirements, check the website of each supplier, and keep checking because these rules are constantly changing, and we are not responsible for those changes.

I guarantee that all payments will be made to TOLI on time.

I agree to abide by all guidelines set forth by TOLI and its partners.

I agree to keep TOLI informed of any changes to my trip status in a timely manner.

I commit to participating in all training and preparations required, including pre and post trip meetings.