Passengers may carry their own oxygen in an FAA-approved container, but our volunteers are not able to provide any medical service before, during, or after the flight. A letter from a doctor indicating a list of any special equipment needed is required. We cannot accept an application if the person requires any life support equipment, incubator, etc. although foldable walkers and some wheelchairs may be accepted.*

Passengers must arrange their own ground transportation to/from the airport and hotel/lodging (if needed).*

Baggage requirements: Flexible bags are recommended. The baggage must be less than 15 lbs.*

Passengers should have back-up transportation in the event of a last-minute cancellation of our flight for reasons outside of understand Matthew J Hackey, Flight 316 and Pilots for Christ, Intl control such as inclement weather, sickness, or FAA restrictions.*

Passengers must be physically fit to travel in a non-pressurized aircraft up to 11,000 feet MSL without access to lavatory facilities for the duration of the flight. Passenger is able to get into and out of the aircraft with minimal assistance*

Passenger confirms to the best of his/her knowledge that all information submitted on this form is true and correct and accepts all terms, conditions, and limitations set forth by understand Matthew J Hackey, Flight 316 and Pilots for Christ, Intl.*

Assumption of Risk: I understand that flying in any aircraft carries inherent risks, including but not limited to injury, property damage, or death. I choose to participate voluntarily and assume all such risks.*

Release of Liability: I hereby release, waive, and discharge the Organizations, their pilots, volunteers, agents, officers, and affiliates from any and all claims, liabilities, or demands of any kind that may arise from or relate to this flight.*

No Insurance Coverage: I understand that this flight is not covered by commercial liability insurance, and I am not entitled to any compensation in the event of an accident or incident.*

I agree to hold harmless, indemnify, and defend Matthew J Hackey, Flight 316 and Pilots for Christ, Intl., Its members, directors, officers, employees, agents, and contractors along with the heirs, personal representatives, successors, and assigns of each of them from and against all liabilities, penalties, costs, losses, damages, expenses, causes of action, claims, demands, or judgments, including, without limitation, reasonable attorney's fees*

I hereby release, waive, and discharge the Organizations, their pilots, volunteers, agents, officers, and affiliates from any and all claims, liabilities, or demands of any kind that may arise from or relate to this flight.*

Legal Capacity: I affirm that I am of legal age and capacity to sign this waiver, or that my parent or legal guardian is signing on my behalf if I am a minor.*

I am listed as a parent on the birth certificate(s)

I have legally adopted the child(ren)

I have been appointed as the legal guardian

Other basis of parental rights

Do not violate any existing court orders

May conflict with existing court orders, but I am acting to protect myself an/or my child(ren) from immediate harm

I am unsure if my actions comply with existing court order

SAFETY Concerns: I am seeking services due to safety concerns for myself and or my child(ren). I understand that this does not permanently exempt me from legal custody requirements, and I may need to address these matters through appropriate legal channels when it is safe to do so.

Imminent Harm Disclosure: I believe I and or my child(ren) are in imminent danger or harm