Skip to main content


Declaration of Mission Events and Release Form

In exchange for participation in a mission trip organized by CUPS Mission of 2607 Woodruff Rd. Ste E #418, Simpsonville, SC 29681 (CUPS), including but not limited to trips to the Dominican Republic, Malawi, Mexico or any other location where CUPS has ongoing or prospective mission operations, and/or use of any property, facilities or services of CUPS Mission, I agree for myself and (if applicable) for the members of my family, to the following:

  1. AGREEMENT TO FOLLOW DIRECTIONS. I agree to observe and obey all posted rules and warnings, and further agree to follow any oral instructions or directions given by CUPS Mission, or the employees, representatives or agents of CUPS Mission.
  2. ASSUMPTION OF THE RISKS AND RELEASE. I recognize that there are certain inherent risks associated with the above described activities and I assume full responsibility for personal injury to myself and (if applicable) my family members, and further release and discharge CUPS Mission for injury, loss or damage arising out of my or my family’s use of, participation in, or presence upon the facilities of CUPS Mission, whether caused by the fault of myself, my family, CUPS Mission or other third parties.
  3. INDEMNIFICATION. I agree to indemnify and defend CUPS Mission against all claims, causes of action, damages, judgments, costs or expenses, including attorney fees and other litigation costs, which may in any way arise from my or my family’s participation in a CUPS Mission trip, or use of or presence upon the facilities of CUPS Mission.
  4. FEES. I agree to pay for all trip costs communicated to me, including any fees accrued for cancelation or changes to my reservations, as well as all damages to the facilities of CUPS Mission and/or hotels, lodges or mission houses caused by any negligent, reckless, or willful actions by me or my family.
  5. CONSENT FOR MINOR. By filling out the form below, I consent to the participation of my minor child(ren), listed below, on the mission trip, and agree on behalf of the below listed minor(s) to all of the terms and conditions of this Agreement. By signing this Release of Liability, I represent that I have legal authority over and custody of all listed minor children.
  6. MEDICAL AUTHORIZATION. In the event of an incapacitating injury to myself or any injury to the above minor(s) during the above-described activities, I give my permission to CUPS Mission or to the employees, representatives or agents of CUPS Mission to arrange for all necessary medical treatment for which I shall be financially responsible. This temporary authority will begin upon my signing this document and remain in effect until terminated in writing by the undersigned or when the above-described activities are completed. CUPS Mission shall have the following powers:
    1. The power to seek appropriate medical treatment or attention on behalf of my child as may be required by the circumstances, including without limitation, that of a licensed medical physician and/or a hospital;
    2. The power to authorize medical treatment or medical procedures in an emergency situation; and
    3. The power to make appropriate decisions regarding clothing, bodily nourishment and shelter.
  1. APPLICABLE LAW. Any legal or equitable claim that may arise from participation in the above shall be resolved under South Carolina law.
  1. NO DURESS. I agree and acknowledge that I am under no pressure or duress to sign this Agreement and that I have been given a reasonable opportunity to review it before signing. I further agree and acknowledge that I am free to have my own legal counsel review this Agreement if I so desire. I further agree that my payment to CUPS Mission to cover the costs of a mission trip in no way constitutes duress or otherwise nullifies any portion of this agreement.
  2. ARM’S LENGTH AGREEMENT. This Agreement and each of its terms are the product of an arm’s length negotiation between the Parties. In the event any ambiguity is found to exist in the interpretation of this Agreement, or any of its provisions, the Parties, and each of them, explicitly reject the application of any legal or equitable rule of interpretation which would lead to a construction either “for” or “against” a particular party based upon their status as the drafter of a specific term, language, or provision giving rise to such ambiguity.
  3. ENFORCEABILITY. The invalidity or unenforceability of any provision of this Agreement, whether standing alone or as applied to a particular occurrence or circumstance, shall not affect the validity or enforceability of any other provision of this Agreement or of any other applications of such provision, as the case may be, and such invalid or unenforceable provision shall be deemed not to be a part of this Agreement.
  4. DISPUTE RESOLUTION. The parties will attempt to resolve any dispute arising out of or relating to this Agreement through friendly negotiations amongst the parties. If the matter is not resolved by negotiation, the parties will resolve the dispute using the below Alternative Dispute Resolution (ADR) procedure.

Any controversies or disputes arising out of or relating to this Agreement will be submitted to Peacemaker Reconciliation Services ( Any cost of such services will be the responsibility of the party initiating the dispute. The Peacemaker decision will be final, and judgment may be entered upon it by any court having proper jurisdiction.

  1. MEDIA WAIVER. CUPS Mission has my full permission to take photographs, video recordings, and/or audio recordings of myself and/or my family members while engaged in any portion of the activities of the mission trip, and I hereby waive any rights or interest in the images or recordings, as contemplated in this release. I acknowledge that this consent to use images and/or recordings is being made solely for the benefit of the organization and comes without any expectation of monetary compensation or other benefit to me.

By filling out and signing this form, you agree to all terms above:

MM slash DD slash YYYY
MM slash DD slash YYYY