I, ________________________________, have voluntarily joined the International Federation for East Timor Observer Project. While in East Timor, I will be responsible to the International Federation for East Timor and agree to follow IFET's Code of Conduct for this Observer Project.
I understand that I am responsible for my own travel and living expenses, except where other arrangements have been made with my national coordinator.
I understand that there are great differences between East Timor and my own country. These differences include climate, living conditions, diet, water quality, transportation, medical care, and physical safety.
I understand that I may need to camp outside during my stay in East Timor and that if I do receive housing, it may not have either running water or indoor toilet facilities.
I know that transportation in East Timor may not be either as available or as safe as it is in my own country.
I understand that health care facilities in East Timor are limited and that access to all types of health care, including emergency health care may be difficult in some situations. I understand that I will not be able to expect the same type of health care as I would receive in my own country. I understand that I am responsible for taking all health precautions for travel to East Timor, including immunizations and preparation of necessary medication. I have informed the International Federation for East Timor of any condition of my mental or physical health that might affect my participation in the delegation.
I understand that there is violence occurring in East Timor and that the degree, location, and type of violence occurring is constantly changing. I understand that traveling to East Timor involves risks. With this understanding and in consideration of my participation in the International Federation for East Timor Observer Project, I completely accept and assume all responsibility for any and all risks of damage or personal injury which may occur during or result from my participation in the program.
I also hereby release, discharge, and agree to hold harmless the International Federation for East Timor, its members, staff, director, officers, promoters and employees, agents, and successors, from any and all liability, claims, demands, rights or causes of action, present or future, whether known or unknown, anticipated or not anticipated, whether brought on my behalf or for any other person, or by my heirs, executors or assigns, for personal illness, injuries or death, or any damage to or loss of personal property which may occur en route to, during, from or as a result of my participation in the International Federation for East Timor Observer Project.
In signing this document, I express release, discharge, and hold harmless the International Federation for East Timor and the persons described above to the maximum extent permitted by law in any state, territory, district, or country.
I have read the foregoing and sign it voluntarily. I am of sound mind and act of my own free will without any coercion or duress in signing this Waiver of Liability and Assumption of Risk.
I am at least eighteen (18) years of age. I have read and understand
all of the above statements.
Sworn and signed this _______ day of ___________, 199__ by,
_________________________________
Name of participant
_________________________________
Notary Public (name)
_________________________________
Attesting Witness (name)