The health and safety of our volunteers is of paramount importance to
us. To ensure the best possible experience for all of our volunteers, we require your cooperation,
and clear understanding of the following:
We rely on the thoroughness and clarity of the health information you present to us. We do
not share your health information with anyone that does not require it, but we do need to
know about any potential health issue or medication, so we can help you if needed.
Volunteers will be traveling to remote areas with limited access to medical care and
medications. If you require medications, please be sure to pack them with you! If
possible, carry a refill prescription separately, we cannot guarantee a suitable
substitute will be available.
Expect your trip to be physically and emotionally demanding both as a result
of activities and living conditions. During our trips you may experience
significant climate and weather changes, strenuous physical activity, loss
of sleep, and an unfamiliar diet. Only you and your physician can fairly
evaluate your fitness for this kind of activity.
Your trip will require preparation which may include immunizations,
other shots or treatments, or other preparation. Please consult your
physician prior to your trip with adequate time to meet those
demands.
Our employees are not doctors or medical experts. It is your
responsibility to plan and provide for your own health and well
being for the duration of your trip. If you have a potential
health issue or cause for our concern, let us know before your
trip what you require. We will let you know whether and how we
can accommodate you.
By checking the box below, you are indicating that you
have read and understood this information, that you have
spoken with your physician about your intended travel,
and that you will be following their recommendations.
*
Medical Conditions
Current Medications
Dietary Restrictions (Vegetarian, Vegan, Gluten-free, etc.)
Allergies (Nuts, Dairy, Shellfish, etc.)
Potential Allergic Reactions
Covid-19 Vaccinations
BTC requires all volunteers who travel with us
to be vaccinated in order to protect you, the
group you are traveling with, our staff, and our
partners and community members on the ground.
Agreement and Release
THIS AGREEMENT AND RELEASE is between the
volunteer (“Volunteer”) and Bridges to
Community, Inc.(“BTC”). This Agreement
and Release is entered into in
connection with the trip offered by BTC
(“Trip”) under which BTC provides the
opportunity for Volunteer to participate
in volunteer service and cultural
exchanges. Volunteer enters into this
Agreement and Release in consideration
of the opportunity to participate in the
trip and for other good and valuable
consideration, the sufficiency of which
the parties acknowledge.
If Volunteer is younger than 18 years
of age, this Agreement and Release
must be signed by a parent or legal
guardian of Volunteer, and, in such
case, all references below to
Volunteer include his or her parents
or guardian. This document is a
legally binding release, which, in
certain situations, will reduce or
eliminate Volunteer's legal rights
and legal recourse. Please read it
carefully before signing.
By choosing to submit this form
as an electronic document, your
completion of the check boxes
and signature fields below will
be considered the same as your
signature on a printed document.
* By completing these
fields and entering your
name below, you are
agreeing to the terms
and policies contained
herein.
Parent/Guardian signature if under 18:
Payment Policy
Payments may be made by credit
card via telephone, online, or
by regular mail. We accept Visa
,Mastercard, and American
Express. We will also accept
checks made payable to Bridges
to Community,Inc. All payments
must indicate the name of the
project or volunteer for whom
they're intended, as well as the
dates of the trip.
Project Cost
The project cost must be
paid in full no later
than six (6) weeks prior
to the date the group is
set to travel.
BTC will only guarantee
your trip and itinerary
if they project cost has
been paid in full.
Failure to pay the
project cost will result
in BTC cancelling your
trip. All donations and
payments made toward the
project cost and
received by BTC are
nonrefundable.
In the event that a
group does not fully
pay for the project
before the scheduled
trip date, BTC will
hold the project
funds to be used for
a future trip within
one (1) calendar
year. If the group
does not reschedule
a trip within that
time period, BTC
reserves the right
to use the funds
received to complete
the project and/or
apply the funds to
our general
programming.
Volunteer Trip Fee
The
completed
Volunteer
Application
and the
balance
of your
volunteer
trip fee
must be
submitted
no later
than six
(6)
weeks
prior to
the
start of
your
trip.
Trip Cancellation by BTC
At
any
time
prior
to
the
Program
start
date,
BTC
may,
at
its
sole
discretion,
cancel
a
Volunteer's
registration,
or
cancel
the
trip
in
which
Volunteer
is
scheduled
to
participate.
In
the
unlikely
event
of
such
a
cancellation,
trip
fees
paid
to
BTC
by
Volunteer
for
that
trip
may
be
refunded.
In
the
unlikely
event
of
such
a
cancellation,
BTC
will
hold
project
related
funds
and
attempt
to
reschedule
the
volunteer
group
within
one
calendar
year.
In
the
event
of
a
cancellation
by
BTC
due
to
any
extraordinary
event
or
circumstance
beyond
the
control
of
BTC,
such
as
a
war,
strike,
riot,
act
of
terrorism,
or
an
event
described
by
the
legal
term
"Act
of
God"
(such
as
hurricane,
flooding,
earthquake,
volcanic
eruption,etc.),
beyond
the
control
of
BTC
that,
in
the
sole
opinion
of
BTC,
renders
travel
or
participation
in
a
trip
unsafe
or
impracticable,
trip
fees
will
be
refunded
with
the
exception
of
the
$250
deposit
and
BTC
will
hold
project
related
funds
and
attempt
to
reschedule
the
volunteer
group
within
one
calendar
year.
In
those
and
all
other
circumstances,
BTC
shall
not
be
responsible
to
Volunteer
for
any
other
refund,
costs,
interest,
liability,
losses,
or
damages
of
any
kind,
including
airfare.
Withdrawal by Volunteer
If
Volunteer
withdraws
for
any
reason,
Volunteer
must
notify
BTC
in
writing.
If
Volunteer
voluntarily
withdraws
from
the
trip,
funds
paid
by
Volunteer
to
BTC
will
be
refunded
only
as
set
forth
below:
A trip
fee
deposit
of
$500
deposit
will
not
be
refunded.
Any
further
trip
Fee
payments
made
may
be
refunded
or
held
for
a
future
trip
within
one
(1)
calendar
year.
No
portion
of
any
Trip
Fee
paid
shall
be
refunded
if
the
withdrawal
is
received
one
week
before
the
trip
start
date.
Changes
to
and
cancellation
of
airfares
are
subject
to
the
regulations
of
the
providers,
and
any
travel
fees,
charges,
expenses
or
penalties
that
might
result
from
any
cancellation
of
or
withdrawal
from
the
trip
will
be
the
sole
responsibility
of
the
Volunteer.
Alterations to Program
BTC
reserves
the
right
to
change
the
trip
due
to
severe
weather,
acts
of
war
or
terrorism,
or
other
causes
beyond
our
control.
In
such
cases
we
will
make
our
best
effort
to
offer
alternate
dates
for
travel.
BTC
will
not
be
responsible
for
any
additional
costs
associated
with
such
circumstances.
If
Volunteer
withdraws
from
the
trip
due
to
such
causes,
the
same
withdrawal
policy
as
above
will
remain
in
effect.
Volunteer's
Responsibility
for
Costs,
Third-Party
Suppliers
The
trip
fee
covers
all
food,
water,
lodging,
in-country
ground
transportation,
administrative
expenses,
and
program
costs.
Volunteer
is
responsible
for
Travel
to
and
from
the
starting
point
of
the
trip,
which
begins
at
the
airport
of
your
trip's
country
destination.
any
additional
costs
incurred
during
free
time,
personal
time,
or
on
activities
which
are
outside
the
trip,
any
costs
incurred
should
Volunteer
be
injured,
become
sick,
or
otherwise
require
a
doctor’s
visit
or
hospitalization,
or
withdraw
early
from
or
remain
past
the
time
scheduled
for
the
trip.
BTC
is
not
responsible
for
the
acts
or
failures
to
act
of
anyone
who
provides
goods
or
services
in
connection
with
the
trip.
In
addition,
BTC
is
not
responsible
for
any
costs,
losses,
damages,
interest,
or
penalties
that
Volunteer
may
incur
because
of
delays
or
losses
caused
by
any
airline,
other
transportation
or
car
rental
company,
travel
agent,
hotel,
restaurant,
medical
facility
or
other
individual
or
organization
providing
goods
or
services,
regardless
of
who
arranged
or
paid
for
such
goods
or
services,
or
because
of
any
act
or
failure
to
act
by
any
governmental
entity,
including
any
delay
or
change
of
travel
plans
caused
by
any
action
by
any
governmental
entity.
Dismissal
from
the
Program
BTC
has
the
authority
at
any
time
and
in
its
sole
discretion
to
dismiss
Volunteer
from
the
trip.
Causes
for
dismissal
may
include,
but
are
not
limited
to:
Behavior
that
is
destructive,
abusive,
violent,
or
involves
harassment,
theft,
vandalism,
or
chronic
defiance
of
policies.
Refusal
to
abide
by
the
laws
and
regulations
of
the
country
and
local
community
or
of
the
United
States
of
America
and
/or
the
State
of
New
York,
or
to
behave
in
a
manner
that
is
appropriate
therein,
all
as
determined
by
BTC
in
its
sole
discretion.
Engaging
in
inappropriate
sexual
activity,
unauthorized
absence
from
the
group,
or
failure
to
abide
by
curfews
and/or
other
set
policies
or
expectations.
Possession
or
use
of
any
weapons,
non-prescribed
drugs,
or
narcotics.
Deterioration
of
Volunteer's
physical
health
or
mental
condition.
BTC
personnel
may
discuss
Volunteer's
situation,
including
Volunteer's
health,
physical,
or
mental
condition,
with
any
person,
including
other
BTC
personnel,
family
members,
or
medical
personnel,
and
release
any
information
concerning
Volunteer
to
such
person.
If
Volunteer
is
dismissed
from
the
trip,
BTC
will
provide
transport
to
the
appropriate
airport
or
will
arrange
for
other
means
of
departure.
Volunteer
will
be
responsible
for
all
costs
incurred
as
a
result
of
such
dismissal,
and
there
will
be
no
refund
of
all
or
any
portion
of
the
Program
Fee.
Personal Property Loss
BTC
takes
all
reasonable
measures
to
ensure
the
security
of
Volunteer's
personal
belongings.
However,
petty
theft
occurs
worldwide.
BTC
will
not
be
held
responsible
for
the
loss
of,
theft
of,
or
damage
to,
Volunteer's
personal
property
or
equipment.
BTC
strongly
advises
Volunteer
not
to
bring
expensive
or
irreplaceable
items
including,
but
not
limited
to,
cameras,
computers,
portable
music
players,
cell
phones,
other
electronic
equipment,
and/or
jewelry
on
the
Program.
Medical Insurance and Emergency Treatment
It
is
highly
recommended
that
volunteers
purchase
"Trip
Cancellation
Insurance"
at
the
same
time
they
register
for
the
trip
to
protect
their
investment.
BTC
will
provide
emergency
medical
evacuation
insurance
to
all
Volunteers
and
maintain
employer's
liability
insurance
for
any
claims
by
Volunteers
as
part
of
the
trip
fee.
Volunteer
acknowledges
that
all
information
that
Volunteer
has
supplied
to
BTC
concerning
his
or
her
medical
condition
and
physical
and
mental
health
is
accurate
and
complete.
Volunteer
acknowledges
they
have
reviewed
the
emergency
medical
evacuation
insurance
coverage
(provided
upon
request)
and
are
aware
of
the
coverage
limits
of
that
insurance.
Volunteers
should
check
with
their
medical
insurance
carrier
and
be
aware
of
the
limits
of
their
own
medical
coverage
while
traveling
internationally.
Volunteers
should
make
arrangements
to
provide
additional
or
supplemental
insurance
to
provide
for
such
coverage,
in
the
case
where
medical
services
are
required.
Should
any
medical
emergency
arise
which
precludes
Volunteer's
ability
to
consent
to
emergency
treatment,
BTC
will
endeavor
to
communicate
with
the
person
designated
by
Volunteer
to
request
permission
for
any
necessary
treatment.
If
BTC
personnel
believe,
in
their
sole
discretion,
that
time
or
circumstances
do
not
permit
such
communication,
Volunteer
authorizes
BTC
to
consent
on
their
behalf
to
any
medical
treatment,
including
all
types
of
medical
examinations,
diagnosis,
medication,
or
physician
or
hospital
care,
that
is
deemed
advisable
by,
and
is
to
be
rendered
under
the
general
or
special
supervision
of
any
hospital,
medical
clinic
or
physician.
Volunteer
agrees
not
to
hold
BTC
responsible
for
actions
or
consequences
relating
to
any
such
medical
or
emergency
treatments
or
the
failure
to
provide
such
medical
treatment.
Miscellaneous
Governing
Law:
This
Agreement
shall
be
governed
by
the
laws
of
the
State
of
New
York
and
any
action
to
enforce,
construe
or
modify
this
Agreement
shall
be
filed
in
the
federal
or
state
courts
in
the
County
of
Westchester
in
the
State
of
New
York.
Attorney
Fees:
The
non-prevailing
party
will
pay
the
prevailing
party
its
attorneys’
fees
and
costs
in
any
legal
proceeding
brought
by
the
prevailing
party
to
enforce
the
terms
of
this
Agreement.
Severability:
Each
provision
of
this
Agreement
shall
be
considered
severable.
If
for
any
reason
any
provision
herein
is
determined
to
be
invalid,
such
invalidity
shall
not
impair
or
otherwise
affect
the
validity
of
the
other
provisions
of
this
Agreement.
Moreover,
the
Parties
agree
to
replace
such
invalid
provision
with
a
substitute
provision
that
will
satisfy
the
intent
of
the
Parties.
Entire
Agreement:
This
Agreement
represents
the
entire
agreement
of
the
Parties
and
may
not
be
changed
except
by
a
written
document
signed
by
both
Parties.
Use of Volunteer's Likeness
Volunteer
consents
to
the
use
of
Volunteer's
likeness
(whether
photographed,
filmed
or
videotaped)
and/or
oral
or
written
comments
or
any
portion
thereof,
in
any
manner
now
or
in
the
future,
including,
without
limitation,
in
fund-raising
and
promotional
materials,
advertising
for
television,
radio,
print
or
other
media,
and
any
other
BTC
presentations
or
publications.
Volunteer
agrees
that,
in
connection
with
such
use,
BTC,
and
persons
acting
for
or
on
behalf
of
BTC,
may
identify
Volunteer
by
name,
age,
city
and/or
state
or
country
of
residence.
Acknowledgment and Release
Volunteer
acknowledges
that
the
trip
involves
travel
to
a
developing
country
with
a
possibly
unstable
political
system
and
differing
cultural
expectations
and
practices.
Volunteer
acknowledges
that
there
are
risks
inherent
in
such
trips,
including,
but
not
limited
to,
forces
of
nature,
accident
or
illness
in
remote
places
without
immediate
access
to
adequate
medical
facilities,
a
lower
standard
of
sanitation,
work
site
injury,
waterborne
infections
and
diseases,
insect
and
animal
bites,
and
travel
by
air,
automobile,
truck,
on
foot
or
by
other
conveyance.
As
stated
in
the
health
information
section,
Volunteers
must
provide
complete
and
current
health
information,
and
are
strongly
advised
to
consult
a
medical
doctor
for
information
about
immunizations,
your
physical
preparedness
to
undertake
strenuous
work
activities
at
one
of
the
work
sites,
and
any
medications
that
may
be
necessary.
Volunteer
assumes
all
the
risks
of
the
trip,
including
health
and
personal
safety
risks,
and
waives
all
claims
for
loss
or
injury
to
person
or
property
while
participating
in
any
of
the
activities
contemplated
thereby,
whether
such
damage,
loss,
or
injury
results
from
the
negligence
of
BTC
or
its
officers,
directors,
representatives,
employees,
liability
insurance
carriers
or
agents,
or
from
any
other
cause.
Therefore,
in
consideration
of
the
right
to
participate
in
the
trip,
and
of
the
services,
food
and
transportation
arranged
by
BTC,
and
its
agents
and
associates,
the
undersigned
Volunteer,
intending
to
be
legally
bound,
consents
to
the
assumption
of
such
risks,
and
agrees
to
forever
waive,
discharge
and
release
for
Volunteer
and
Volunteer's
heirs,
executors,
and
administrators,
all
rights
and
claims
for
injuries,
damages,
illness,
losses,
demands
and
other
actions
of
every
kind
and
nature
whatsoever,
which
Volunteer
may
have
against
BTC
or
its
officers,
directors,
employees,
liability
insurance
carriers
and
agents
and
all
of
those
entities'
representatives,
successors
and
assigns,
resulting
from
or
in
connection
with
the
trip
or
any
other
activities
arranged
for
Volunteer
by
BTC
and/or
its
agents
and
associates.
*
Final Signatures
By entering your name in the fields
below, you are agreeing to the terms
and conditions described within our
application form, you are agreeing
to be charged the fee(s) associated
with this volunteer trip, and you
are agreeing that the information
you have provided is truthful and
complete.
Volunteers under eighteen (18)
years old MUST have a parent or
other legal guardian enter their
name.
* Send Registration
