Holy Land Pre Registration

This is your first step in registering for our Holy Land 2019 trip. Completing this form does not obligate you to participating. If you are a UNC Charlotte student, please complete the scholarship section. When reviewed, we will send you a scholarship declaration to help you make your final decision on the trip. When this process is complete, we will help you with step two, registering with the tour company. Also, if you do not have a passport, no worries - but you will need to get one.
Pre Registering does not lock you into the trip. This allows our staff to evaluate student scholarship requests and monitor student - non-student ratios. Pre Registration also allows you to complete our liability release form.
Your Name

 
Personal Information

 
 
 
 
 
 
 
Student Scholarship Info

 
 
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Emergency Information

 
 
 
 
 
 
 
 
 
 
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Travel Destination

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Travel Insurance

Niner United trips are non-refundable, because even if you cancel, we will be stuck with the bill. Trip Insurance, however, issues refunds for emergency situations. If you need to cancel your trip due to medical issues, a death in the family, etc. trip insurance will work. You will need to submit a claim and provide as much documentation to the insurer, such as a letter from your doctor, as possible to ensure you receive a full refund. EO Tours, our host company, provides this service for $299 for students, $349 for non-students.
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Release of Liability

RELEASE OF LEGAL RIGHTS – READ AND UNDERSTAND BEFORE SIGNING

THIS AGREEMENT APPLIES TO COOPERATIVE CHRISTIAN MINISTRY IN HIGHER EDUCATION. THIS AGREEMENT CONSTITUTES AN EXPRESS CONTRACTUAL ASSUMPTION OF ALL RISKS, AND BOTH A WAIVER AND RELEASE FROM ALL LIABILITY FOR ANY NEGLIGENCE OR DANGEROUS CONDITIONS OF ACTIVITIES AND TRIPS AND INDEMNITY FOR ALL THIRD PARTY CLAIMS (HEREINAFTER "AGREEMENT").

By this Agreement, it is my intention to forever relieve COOPERATIVE CHRISTIAN MINISTRY IN HIGHER EDUCATION, INC., its directors, employees, agents, volunteers, sponsors, and partners (hereinafter "CCMHE") of any duty to me and I do assume the entire risk of any personal injury, damage, loss, harm, death, claim, medical expense and any other type of expense that might occur during or as a result of my use of, or presence at ANY CCMHE SPONSORED activity, (hereinafter “The Trip”). By this Agreement, I also intend to forever release, discharge and absolve CCMHE from any and all liability for any active or passive negligence whatsoever by CCMHE and to waive and relinquish any claim or cause of action against CCMHE for any personal injury, damage, loss, harm, death, medical expense and any other type of expense caused by any negligence of CCMHE and promise not to sue or exercise any legal right to seek damages from CCMHE. By this Agreement, I also intend to forever release, discharge, waive and relinquish and absolve CCMHE from any and all claims or causes of action against CCMHE for any personal injury, damage, loss, harm, death, medical expense and any other type of expense caused by the condition, maintenance, and/or action of The Trip and promise not to sue or exercise any legal right to seek damages from CCMHE.

In consideration for being accepted by CCMHE for participation in any activity for the present calendar year, I being 18 years of age or older, do for myself as participant hereby assume all risk of personal injury, sickness, death, damage, and expense which I may incur as a result of the negligence of CCMHE during participation in recreation, work, and campus ministry activities involved, and appreciate and agree to the following conditions: I the undersigned, on his or her own behalf, agree that I shall comply with the stated terms, rules and conditions for participation in any program at CCMHE. In addition, if I observe any hazard during participation, I will bring it to the attention of the nearest CCMHE official immediately; I am aware that participation in CCMHE programs may create a risk of injury, and I, on behalf of myself, knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of others; and I for myself and my respective heirs, assigns, administrators, personal representatives, and next of kin, hereby release and hold harmless CCMHE from and against any and all claims, injuries, liabilities, or damages arising out of or related to participation in any and all programs, activities, trips or events. I further agree that I shall hold harmless and fully indemnify the parties hereby released from any claims, damages, and costs including attorney fees which may arise from any claim or cause of action made by me, through me or on my behalf even if caused in whole or in part by any of the parties or entities hereby released. I also understand that this Release binds my heirs, executors, administrators, and assigns, as well as myself

In consideration of participating in The Trip, I hereby agree:

a. To forever waive any and all claims for any injury and/or damages that I may have against CCMHE or any other person, company or entity in any way associated with it;

b. To forever release CCMHE from any and all liability for any injury and/or damages that I may suffer or incur, or that my next of kin may suffer as a result of my participation in any activity;

c. To forever hold harmless and indemnify CCMHE from any and all liability for any injury and/or damages to any third party resulting from my participation in any activity.

This waiver and release of liability and indemnification agreement shall be effective and binding upon my heirs, next of kin, family, relatives, guardians, conservators, executors, administrators, trustees and assigns in the event of my injury, disability or death.

I further understand and agree to be bound by the following:

I have agreed to undertake and participate in a trip arranged by Cooperative Christian Ministry in Higher Education, Inc. (“CCMHE”), a campus ministry serving Charlotte, North Carolina (the “Trip”). I have chosen to undertake the Trip voluntarily. This form confirms my understanding of and agreement to the following:

1. Risks of Travel. I understand that participation in the Trip may involve risks. These include, without limitation, risks involved in traveling to and within, and returning from urban areas, districts with high crime rates, health clinics, overnight shelters and ministries serving those in poverty. The areas to which I travel may have health and safety issues that differ from what may be considered standard, and I recognize that I may be subjected to potential risks, illnesses, injuries and even death. I understand these risks and assume them knowingly and willingly. I also acknowledge that it is my responsibility to take every precaution to safeguard my health and to protect my personal belongings from damage or theft. I acknowledge that CCMHE recommends that I never travel alone, particularly at night. Being alone, especially at night, may present additional danger to my safety and well being. Although CCMHE is providing financial assistance and administrative planning for the Trip, CCMHE’s evaluation of the Trip has been solely on its spiritual merits. Among other things, CCMHE is not in the position to evaluate, and therefore has not evaluated, whether the Trip will take place in a safe and secure environment. These are judgments that I recognize I must independently make.

2. Risks of Travel Supplement. I have read and understand the U.S. Department of State Travel Information, Alert, Advisory, and/or Warning for the country to which I will be traveling. I acknowledge that I am solely responsible for any legal problems I encounter with any foreign nationals or government and that CCMHE has no obligation to provide any assistance under such circumstances. I understand that the U.S. Government may not be able to provide me any legal, medical or emergency assistance while I am in the country of travel. I have discussed the travel status and travel to the country with the CCMHE staff and have been afforded the opportunity to ask questions of the Director.

3. Health Insurance; Medical Care. I will carry valid and current medical insurance and have a valid insurance identity card to bring. I have reviewed my coverage and have determined that this insurance is adequate to cover injuries or illnesses that I may sustain while traveling. I will be solely responsible for payment in full of all costs of medical care I may receive while on the Trip. I am also aware that when I participate in this Trip, CCMHE will register me for domestic travel insurance, for which my eligibility and enrollment will be automatic. The coverage offers medical information and evacuation, and emergency assistance, and is a supplement to, not a substitute for, health insurance.

4. Medical Release. In the event that I am injured or require the attention of a physician, I consent to any reasonable medical treatment as deemed necessary by a licensed physician. In the event treatment is required from a physician and/or hospital designated by CCMHE’s leadership, I agree to hold this leader and CCMHE free and harmless of any claims, demands, or suits for damages arising from the giving of such consent.

5. Standards of Conduct. I recognize that I assume an important personal obligation to conduct myself in a manner compatible with local and federal laws and regulations. I promise to act responsibly and will refrain from the consumption or possession of illegal products.

6. Travel Arrangements. I understand that CCMHE does not represent or act as an agent for, and cannot control the acts or omissions of, any host, transportation carrier, hostel, hotel, organizer, provider of food, goods or services involved in the Trip. I understand CCMHE is not responsible for matters that are beyond its control, and that it cannot warrant the safety or convenience of the circumstances under which I will be participating.

7. Permission to Use Photograph. I grant to CCMHE, its represenatatives and employees the right to photograph me authorize CCMHE, its assigns and transferees to copyright, use, and publish the same in print or electronically. I agree that CCMHE may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and web content.

8. General Relea RELEASE OF LEGAL RIGHTS – READ AND UNDERSTAND BEFORE SIGNING

THIS AGREEMENT APPLIES TO COOPERATIVE CHRISTIAN MINISTRY IN HIGHER EDUCATION. THIS AGREEMENT CONSTITUTES AN EXPRESS CONTRACTUAL ASSUMPTION OF ALL RISKS, AND BOTH A WAIVER AND RELEASE FROM ALL LIABILITY FOR ANY NEGLIGENCE OR DANGEROUS CONDITIONS OF ACTIVITIES AND TRIPS AND INDEMNITY FOR ALL THIRD PARTY CLAIMS (HEREINAFTER "AGREEMENT").

By this Agreement, it is my intention to forever relieve COOPERATIVE CHRISTIAN MINISTRY IN HIGHER EDUCATION, INC., its directors, employees, agents, volunteers, sponsors, and partners (hereinafter "CCMHE") of any duty to me and I do assume the entire risk of any personal injury, damage, loss, harm, death, claim, medical expense and any other type of expense that might occur during or as a result of my use of, or presence at ANY CCMHE SPONSORED activity, (hereinafter “The Trip”). By this Agreement, I also intend to forever release, discharge and absolve CCMHE from any and all liability for any active or passive negligence whatsoever by CCMHE and to waive and relinquish any claim or cause of action against CCMHE for any personal injury, damage, loss, harm, death, medical expense and any other type of expense caused by any negligence of CCMHE and promise not to sue or exercise any legal right to seek damages from CCMHE. By this Agreement, I also intend to forever release, discharge, waive and relinquish and absolve CCMHE from any and all claims or causes of action against CCMHE for any personal injury, damage, loss, harm, death, medical expense and any other type of expense caused by the condition, maintenance, and/or action of The Trip and promise not to sue or exercise any legal right to seek damages from CCMHE.

In consideration for being accepted by CCMHE for participation in any activity for the present calendar year, I being 18 years of age or older, do for myself as participant hereby assume all risk of personal injury, sickness, death, damage, and expense which I may incur as a result of the negligence of CCMHE during participation in recreation, work, and campus ministry activities involved, and appreciate and agree to the following conditions: I the undersigned, on his or her own behalf, agree that I shall comply with the stated terms, rules and conditions for participation in any program at CCMHE. In addition, if I observe any hazard during participation, I will bring it to the attention of the nearest CCMHE official immediately; I am aware that participation in CCMHE programs may create a risk of injury, and I, on behalf of myself, knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of others; and I for myself and my respective heirs, assigns, administrators, personal representatives, and next of kin, hereby release and hold harmless CCMHE from and against any and all claims, injuries, liabilities, or damages arising out of or related to participation in any and all programs, activities, trips or events. I further agree that I shall hold harmless and fully indemnify the parties hereby released from any claims, damages, and costs including attorney fees which may arise from any claim or cause of action made by me, through me or on my behalf even if caused in whole or in part by any of the parties or entities hereby released. I also understand that this Release binds my heirs, executors, administrators, and assigns, as well as myself

In consideration of participating in The Trip, I hereby agree:

a. To forever waive any and all claims for any injury and/or damages that I may have against CCMHE or any other person, company or entity in any way associated with it;

b. To forever release CCMHE from any and all liability for any injury and/or damages that I may suffer or incur, or that my next of kin may suffer as a result of my participation in any activity;

c. To forever hold harmless and indemnify CCMHE from any and all liability for any injury and/or damages to any third party resulting from my participation in any activity.

This waiver and release of liability and indemnification agreement shall be effective and binding upon my heirs, next of kin, family, relatives, guardians, conservators, executors, administrators, trustees and assigns in the event of my injury, disability or death.

I further understand and agree to be bound by the following:

I have agreed to undertake and participate in a trip arranged by Cooperative Christian Ministry in Higher Education, Inc. (“CCMHE”), a campus ministry serving Charlotte, North Carolina (the “Trip”). I have chosen to undertake the Trip voluntarily. This form confirms my understanding of and agreement to the following:

1. Risks of Travel. I understand that participation in the Trip may involve risks. These include, without limitation, risks involved in traveling to and within, and returning from urban areas, districts with high crime rates, health clinics, overnight shelters and ministries serving those in poverty. The areas to which I travel may have health and safety issues that differ from what may be considered standard, and I recognize that I may be subjected to potential risks, illnesses, injuries and even death. I understand these risks and assume them knowingly and willingly. I also acknowledge that it is my responsibility to take every precaution to safeguard my health and to protect my personal belongings from damage or theft. I acknowledge that CCMHE recommends that I never travel alone, particularly at night. Being alone, especially at night, may present additional danger to my safety and well being. Although CCMHE is providing financial assistance and administrative planning for the Trip, CCMHE’s evaluation of the Trip has been solely on its spiritual merits. Among other things, CCMHE is not in the position to evaluate, and therefore has not evaluated, whether the Trip will take place in a safe and secure environment. These are judgments that I recognize I must independently make.

2. Risks of Travel Supplement. I have read and understand the U.S. Department of State Travel Warning for the country to which I will be traveling. I acknowledge that I am solely responsible for any legal problems I encounter with any foreign nationals or government and that CCMHE has no obligation to provide any assistance under such circumstances. I understand that the U.S. Government may not be able to provide me any legal, medical or emergency assistance while I am in the country of travel. I have discussed the travel warning and travel to the country with the CCMHE staff and have been afforded the opportunity to ask questions of the Director.

2. Health Insurance; Medical Care. I will carry valid and current medical insurance and have a valid insurance identity card to bring. I have reviewed my coverage and have determined that this insurance is adequate to cover injuries or illnesses that I may sustain while traveling. I will be solely responsible for payment in full of all costs of medical care I may receive while on the Trip. I am also aware that when I participate in this Trip, CCMHE will register me for domestic travel insurance, for which my eligibility and enrollment will be automatic. The coverage offers medical information and evacuation, and emergency assistance, and is a supplement to, not a substitute for, health insurance.

3. Medical Release. In the event that I am injured or require the attention of a physician, I consent to any reasonable medical treatment as deemed necessary by a licensed physician. In the event treatment is required from a physician and/or hospital designated by CCMHE’s leadership, I agree to hold this leader and CCMHE free and harmless of any claims, demands, or suits for damages arising from the giving of such consent.

4. Standards of Conduct. I recognize that I assume an important personal obligation to conduct myself in a manner compatible with local and federal laws and regulations. I promise to act responsibly and will refrain from the consumption or possession of illegal products.

5. Travel Arrangements. I understand that CCMHE does not represent or act as an agent for, and cannot control the acts or omissions of, any host, transportation carrier, hostel, hotel, organizer, provider of food, goods or services involved in the Trip. I understand CCMHE is not responsible for matters that are beyond its control, and that it cannot warrant the safety or convenience of the circumstances under which I will be participating.

6. Permission to Use Photograph. I grant to CCMHE, its represenatatives and employees the right to photograph me authorize CCMHE, its assigns and transferees to copyright, use, and publish the same in print or electronically. I agree that CCMHE may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and web content.

7. General Release. Knowing the risks described above, I agree, on behalf of my family, heirs and personal representative(s), to assume all the risks and responsibilities surrounding my participation in the Trip. To the maximum extent permitted by law, I forever waive, release, hold harmless and agree to indemnify CCMHE and its officers, directors, staff, representatives and agents, from and against any present or future claim, loss or liability for injury to person or property which I may suffer, or for which I may be liable to any other person, related to my participation in the Trip (including periods in transit to or from my destination), resulting from any case, including but not limited to ordinary or gross negligence.

I HAVE READ AND VOLUNTARILY SIGN THIS AGREEMENT, and further agree that no oral representations, statements, or inducements apart from this Agreement have been made by CCMHE with regard to the subject matter of this Agreement.

Severability. If any provision of this Agreement is held as a matter of law to be unenforceable, the remainder of this Agreement shall be enforceable without such provision. Terms of the Agreement that conflict with the statues of the state in which the Agreement was signed are hereby amended as necessary to conform to such statues.
. Knowing the risks described above, I agree, on behalf of my family, heirs and personal representative(s), to assume all the risks and responsibilities surrounding my participation in the Trip. To the maximum extent permitted by law, I forever waive, release, hold harmless and agree to indemnify CCMHE and its officers, directors, staff, representatives and agents, from and against any present or future claim, loss or liability for injury to person or property which I may suffer, or for which I may be liable to any other person, related to my participation in the Trip (including periods in transit to or from my destination), resulting from any case, including but not limited to ordinary or gross negligence.

I HAVE READ AND VOLUNTARILY SIGN THIS AGREEMENT, and further agree that no oral representations, statements, or inducements apart from this Agreement have been made by CCMHE with regard to the subject matter of this Agreement.

Severability. If any provision of this Agreement is held as a matter of law to be unenforceable, the remainder of this Agreement shall be enforceable without such provision. Terms of the Agreement that conflict with the statues of the state in which the Agreement was signed are hereby amended as necessary to conform to such statues.
Please select one option.
 

Description

This is your first step in registering for our Holy Land 2019 trip. Completing this form does not obligate you to participating. If you are a UNC Charlotte student, please complete the scholarship section. When reviewed, we will send you a scholarship declaration to help you make your final decision on the trip. When this process is complete, we will help you with step two, registering with the tour company. Also, if you do not have a passport, no worries - but you will need to get one.