Consent Form

This Form records the Volunteer's acceptance of a Placement managed by The Leap Overseas Limited (the "Company") subject to the Company's Booking Conditions (the "Booking Conditions"), Placement Guidelines and this Form. Unless inconsistent with the context, words or expressions defined in the Booking Conditions bear the same meaning.

1.    Name……………………………………………………………………………………………………………………………………………… of

    Address................................................................................................................................................................ (the "Volunteer")

    accepts a Placement with the Company in……………………………………………………………………………   [Country] at

    …………………………………………………………………………………………………………………………………………………………   [Placement Name]

    to commence on……………………………... [Date: Month/Year] for a duration of………                [Number] weeks subject to the company Booking Conditions and Placement Guidelines.

2.      The Volunteer has read and fully understands the Company's Booking Conditions (the "Booking Conditions") and agrees that his/her participation in the Placement will be subject to this Consent and Acceptance Form, the Booking Conditions and the Placement Guidelines only and in any event agrees to abide by the terms of the Booking Conditions (which are accessible on the Company's website) the Placement Guidelines and this Consent and Acceptance Form.

3.      The Volunteer hereby consents to the following
3.1    That although the Company will do all it can to ensure that the information provided to the Volunteer regarding the Placement is accurate and up to date and that Placements and other activities are satisfactorily arranged, the Company cannot accept liability for any loss or damage including consequential loss suffered by any Volunteer in connection with information, advice or any introduction given by or on behalf of the Company, and/or where caused by any third party.
3.2    During the Placement the Volunteer is responsible for his/her own actions and as such will take all relevant and necessary precautions in all his/her activities.
3.3    By signing this agreement the Volunteer is not precluded from always having the right to pursue a claim and/or receive any benefits which may be properly payable to the Volunteer under the terms of any individual insurance policy.

4.      The Volunteer agrees to the following:
4.1    To comply with any local rules and/or laws including, but not limited to, dress and/or behaviour.
4.2    To strictly adhere to The Leap's Values (which are accessible on the Company’s website).
4.3    To not undertake nor seek to undertake either directly, indirectly or through the medium of an agent any private contract regarding any aspect of the Placement between a third party and themselves during the period of their participation in the Placement.
4.4    To contract exclusively with the Company regarding the Placement and during the period of their Placement be an ambassador of the Company and act accordingly.
4.5    To allow The Leap to speak to their parents or Next of Kin in the event of a problem or emergency.
4.6    To adhere to the Placement Guidelines provided by the Company and such other regulations and guidelines agreed by the Company and the Work Placement Host of the Project to which the Volunteer has been or will be assigned. The Company will use its reasonable endeavours to correct any problems consequent to the Placement Guidelines made known by the Volunteer to the Work Placement Host.

Awareness of Risk
5.      The Volunteer acknowledges:
5.1    That by undertaking the Placement, the Volunteer consents to work in an environment, which may involve an element of risk; in particular, but not limited to, the risk of wild animals, forces of nature, accident through travel or transportation, in-country disruption of services by war or political unrest.
5.2    That the Company has informed the Volunteer of the nature of the risks that the Volunteer will face in completing the Placement (Placement Guidelines and Safety/Travel Advice etc on My Leap), and accordingly the Volunteer understands the need for proper and comprehensive insurance cover in respect of these risks to be in place prior to the commencement of his/her Placement.
5.3    The Company's recommendation of insurance cover, as provided by Global Travel Insurance Limited, details of which will be sent in due course or are available on request.
5.4    That the Company accordingly cannot be held responsible for any such risks and as such releases the Company from any claim that they may have in respect of encountering any such risks.

The Company
6.    The Company for its part will seek so far as is possible to ensure that the Volunteer's Placement is a success but that it cannot, under any circumstances, guarantee the degree of success of the Placement. The success of the Placement depends, in large measure, on the personal commitment given by the Volunteer, and their flexibility and willingness to undertake any task/responsibility demanded of them by the Work Placement Host, including but not limited to manual work such as housekeeping and maintenance (if applicable), in order to meet the Host’s actual requirements as the situation dictates, even if it differs from any information the Volunteer has received prior to departure.

Volunteer's Signature

Signed…………………………………………………………………………………

Date…………………………………………………………

Name......................................................................................................................................

Date of Birth………………………….

DECLARATION AND COUNTER SIGNATURE BY PARENT(S) OR GUARDIAN
*Only required if the Volunteer is under 18 at the time of completing this form.
I have read this Consent and Acceptance Form, the Placement Guidelines and the Company's Booking Conditions and accept their terms. I confirm that I have explained the meaning of the Consent and Acceptance Form, the Placement Guidelines and the Booking Conditions to my son/daughter/ward.

I acknowledge the Company’s recommendation of insurance cover as provided by Global Travel Insurance Limited. I understand the nature of the risks that the Company has recommended that I purchase suitable insurance cover in respect of.

I confirm that on application my son/daughter/ward was under 18 years of age and I accept to be bound by this Consent and Acceptance Form, the Booking Conditions and the Placement Guidelines (all of which I have carefully read) until my son/daughter/ward attains eighteen years of age after which he/she will be bound by them. (*delete as appropriate)

In signing this Consent and Acceptance Form I authorise the Company's employees, agents and representatives to act 'in loco parentis' for my son/daughter/ward for the duration of my son/daughter/ward’s Placement and I hereby give permission to The Company and its staff to give the necessary authority on my behalf for any medical or surgical treatment recommended by competent medical authorities, where it would be contrary to my son/daughter/ward's interest, in the relevant doctor's reasonable medical opinion for any delay to be incurred by seeking my personal consent.

EXECUTED AND DELIVERED AS A DEED
(Signed by Parent/Guardian

………………………………………………………………………………………………………………… in the presence of
(Signed by Witness i.e. other Parent or adult)

……………………………………………………………………………………
Full Name

……………………………………………………………………………………………………………………………………………………
Address

……………………………………………………………………………………………………………………………………………………….
Occupation

………………………………………………………………………………………………………………………………………………….

Please Return to:
The Leap Overseas Ltd, 121 High St, Marlborough, Wiltshire, SN8 1LZ
T: 00 44 (0)1672 519922 F: 00 44 (0)1672 519944 E: info@theleap.co.uk

The Leap is a member of the Year Out Group an association of leading UK organisations formed to promote the concept and benefits of well-structured Year Out programmes

The Leap Overseas Ltd, 121 High Street, Marlborough, Wiltshire SN8 1LZ Tel 01672 519922 Fax 01672 519944 Email info@theleap.co.uk