Mission Registration

報名表，每個人都要填寫
Mission Registration Form
( Everyone needs to fill out)

* Indicates required field

你是領隊嗎？ Are you the mission team leader? *

短宣日期 Mission Date *

名字 Name *

First

Last

電郵信箱 Email *

聯絡電話 Phone No. *

Release of Liability and Consent to Treatment

Whereas, I plan to participate in Mission ministry and related activities sponsored by the AIT Mission and Whereas, I recognize that the participation in such activities may be hazardous and dangerous.
            Now therefore, in consideration of the privilege to participate extended to me by the AIT Mission , through its officers, agents, servants, and employees, I do hereby, for myself, my heirs, executor and/or administrator, remise, release and discharge AIT Mission and all its officers, agents, servants, and employees acting officially or otherwise; from any and all actions, causes of action, claims and demands for, upon, or by reason of injury, damage, loss, or death which may occur from any cause including but not limited to any accident while participating individually or with others in said events.
            I hereby also authorize the leadership of the said mission team, acting as the team member’s agent, to consent to any x-ray, examination, anesthetic, medical or surgical diagnosis or treatment, and hospital care of service, which is deemed advisable; and is rendered under the general or specific supervision of any licensed physician, surgeon, or the medical staff of a licensed hospital, wherever such diagnosis or treatment is rendered at the office of said physician or at said hospital.
   It is understood that this authorization is given in advance of any specific diagnosis, treatment, or hospital care being rendered, but is given to provide authority on the part of the Agent to give specific consent to any or all such diagnosis, treatment, or hospital care which the above mentioned physician, in the exercise of his/her best judgment, may deem advisable.
   I hereby also authorize any hospital which has provided treatment to the team member to surrender physical custody of the team member to the Agent upon completion of treatment. These authorizations shall remain effective through the below period unless sooner revoked in writing and delivered to the Agent.
I HAVE READ AND AGREED TO THIS RELEASE:

Submit

Mexico Mission Schedule

報名表，每個人都要填寫
Mission Registration Form
( Everyone needs to fill out)

Release of Liability and Consent to Treatment

行程安排，只需領隊填寫，Mission Schedule, Team Leader Only

Mexico Mission Schedule

報名表，每個人都要填寫 ​Mission Registration Form ​( Everyone needs to fill out)​

​Release of Liability and Consent to Treatment

行程安排，只需領隊填寫，Mission Schedule, Team Leader Only

報名表，每個人都要填寫
Mission Registration Form
( Everyone needs to fill out)

Release of Liability and Consent to Treatment