On behalf of all members of my household, I agree to participate by serving as a Host Ambassador for a visiting Costa Rican(s) as part of the adult cultural exchange program of the Oregon-Costa Rica Partners of the Americas. I understand that this program has been approved by the chapters of both Oregon and Costa Rica, and is recognized by the international Partners of the Americas.
I recognize that there may be certain risks of having people visit me/my home and stay/live in my home, and I/we are willing to assume and bear these risks in order to meet and share experiences with a visitor from Costa Rica. Therefore, in consideration of my selection by Oregon-Costa Rica Partners of the Americas as an Host Ambassador for this program, I hereby release, indemnify and hold harmless Oregon-Costa Rica Partners of the Americas and Partners of the Americas International, which includes its Officers, Directors and Volunteers, from any/all claims, actions and causes of action(s) based upon or by reason of any loss, damage or injury to any person or property of any member of the household, arising out of, or in any manner connected with, any aspect of the program. As a Host Ambassador, I/we shall willingly accept in my/our home approved Costa Rican visitors who:
· may be of another race or religious preference;
· may be of another sex or sexual preference; and
· may not speak my language and with whom I/we are not yet familiar
I agree to:
· provide a safe, secure and comfortable room and board for visiting Costa Rican Ambassador(s) for the specified number of days and nights_______________________ (initial)
· involve this visiting ambassador in the daily activities of my household _______________(initial)
· participate in all official functions and activities planned for the visitors during their current trip to my town and/or ensure my visiting guest arrives at and returns from scheduled program activities in a safe and secure manner ______________________ (initial)
· attend area activity planning sessions and any Ambassador training or Q/A sessions offered _____________ (initial)
· accept that this ambassador program is a public event and that the photographs and names of the hosts may be used by local and/or national media in Partners of the Americas publications and promotions. _______________ (initial)
Having read all above information, I agree to be a Host Ambassador for the Oregon-Costa Rican Partners of the Americas and thereby provide goodwill and friendship to the visitor, as the purpose of this adult cultural exchange program is to extend friendships to the citizens of Costa Rica who are members of the Costa Rica Partners of the Americas.
________________________________________ (signed) ________________ (date)