* Require Information
I understand that this document is a request for free disaster relief assistance and that under no circumstance will I be held liable for any payment, now or in the future, for any services rendered unto me by Operation Blessing.
I do hereby release and discharge Operation Blessing, its agents, representatives, directors, employees, contractors, volunteers and assigns, and will hold them harmless from any and all liability and claims, now or in the future, which I or any person claiming through me, may have arising from any repair, renovation, or relief work engaged in by such agents, representative, directors, employees, contractors or assigns on the above premises.
I hereby give Operation Blessing, it’s agents, representatives, directors, employees, contractors, volunteers and assigns permissions to enter onto the aforementioned premises until such time that all requested work is completed.
I have read and fully understand the terms and legal significance of this release and have executed it voluntarily.