We want to help you!
Crisis Response International is currently deployed in your community to assist families and individuals who have experienced trauma and loss. We have trained trauma care specialists who understand how to serve and provide care at sites where properties are destroyed by fire, flood, and other disasters.

Filling out this waiver form allows us to connect with you on your property should you decide you want that.
It gives us your information so we can call you or text you and set up a time to meet you at your residence. We have nothing to sell you. We are here with teams to serve, and we know how.

This simple form is the beginning of us connecting our teams to care.
If you have any questions, please call:  803-766-1223

First Name

Last Name

Phone *

Address

Physical address we show up at *

Country

State

City

Postal Code

Date/Time to Access Property if Requested (you would meet us there)

Number of residents?

Email *

Please select how we can help you

Muck Out

Spiritual, Psychological, Emotional Care

Look for Missing Items

Chainsaw and Tree Work

Is there anything else we should know?

By checking this box, I consent to receive non-marketing text messages from CRISIS RESPONSE INTERNATIONAL about NEW MEXICO FLOOD RELIEF. Message frequency varies, message & data rates may apply. Text HELP for assistance, reply STOP to opt out.

By checking this box, I consent to receive marketing and promotional messages including special offers, discounts, new product updates among others, from CRISIS RESPONSE INTERNATIONAL at the phone number provided. Frequency may vary. Message & data rates may apply. Text HELP for assistance, reply STOP to opt out.

This HOLD HARMLESS AGREEMENT (this "Agreement") is made by and between Crisis Response International (hereinafter, "CRI"), of Dave Lyle Blvd, Rock Hill, SC and the undersigned party who certifies that he/she is the lawful owner, title deed holder and not a renter, lessee or "lease-to-own" or other purchase plan person, of the undersigned address (hereinafter, "Owner"). CRI and Owner are sometimes individually referred to as "party" and collectively referred to as the "parties." WHEREAS, CRI is a 501 (c)(3) non-profit organization that resources, trains and mobilizes volunteers, churches and other organizations to respond to disasters and compassion initiatives around the world. CRI provides a model and framework for responding to disaster situations and delivering resources to areas that would otherwise be off-limits to volunteers. In furtherance of this purpose, CRI manages operations, resources and personnel to carry out various tasks and services that assist victims of disaster and crisis. Operations vary upon the size and scope of the disaster, but ultimately the goal is to see hearts turn to Christ through demonstrations of God's mercy and love. WHEREAS, the Owner is requesting that CRI, through its directors, officers, employees, agents, contractors, and volunteers provide disaster relief to the Owner; and WHEREAS, CRI desires to provide said disaster relief to the Owners. THEREFORE, in consideration of the disaster relief to be provided, and the mutual agreements contained herein, CRI and Owner hereby agree as follows: Owner shall not initiate, maintain, support or bring any legal action against, nor hold liable, CRI, its affiliated, controlled, and supported organizations, directors, officers, employees, agents, contractors, and volunteers, and their successors and assigns (collectively referred to hereinafter as "CRI and its representatives") for any damages of any kind or nature whatsoever arising from the providing of disaster relief services by CRI and its representatives to the Owner. The Owner holds CRI and its representatives harmless, and releases and discharges any and all actions, claims and demands whatsoever that the Owner might now have, or might hereafter arises or accrue, against CRI and its representatives, and any other person, corporation, association or partnership, which might be charged with responsibility for injuries to the person or property, or both, of the Owner, and any consequences flowing therefrom, resulting, or which might result, from CRI providing disaster relief services to the Owner. CRI and its representatives are not making, guaranteeing or providing a warranty as to the competency or professional training of CRI and its representatives, but is simply offering their assistance "AS IS" in aid, comfort and service free of charge to help Owner. The parties acknowledge that CRI and its representatives are providing assistance and service expressly based on terms of this Agreement. Furthermore, Owner shall defend and indemnify CRI and its representatives from any and all actual or alleged claims, demands, causes of action, liability, loss, damage and/or injury (te property or persons, including without limitation wrongful death), whether brought by an individual or other entity, or imposed by a court of law or by administrative action of any federal, state, or local governmental body or agency, arising out of or incident to any acts, omissions, negligence, or willful misconduct of CRI or its representatives or Owner related to or arising from CRI providing assistance and services to Owner. This indemnification applies to and includes, without limitation, the payment of any and all penalties, fines, judgments, awards, decrees, attorneys fees, and related costs or expenses, and any reimbursements to CRI for all legal expenses and costs incurred by it Each party warrants that the individuals who have signed this Agreement have the legal power, right, and authority to enter into and make this Agreement and bind each respective party. No supplement, modification, or amendment of this Agreement shall be binding unless executed in writing and signed by both parties. If any legal action or other proceeding is brought in connection with this Agreement, the prevailing party shall be entitled to recover its reasonable attorneys' fees and other related costs, in addition to any other relief to which the party is entitled. This Agreement shall be governed by and interpreted in accordance with the local state laws, without giving effect to the conflict of law principles thereof. If any clause or provision of this Release shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this Agreement, which shall continue to be enforceable. The parties expressly submit to the exclusive jurisdiction and venue of the Circuit Courts of the County of the property listed above, and waive any and all objections to jurisdiction and venue of any action instituted hereunder, and shall not assert any defense based on lack of jurisdiction or venue or on forum non conveniens. Any judicial proceeding by Owner or CRI, directly or indirectly, in any way arising out of, related to or connected with this Agreement, shall be brought only in the Circuit Court for the county of the subject property above. This Agreement contains the entire agreement between the parties related to the matters specified herein, and supersedes any prior oral or written statements or agreements between the parties related to such matters. THE OWNER HAS HAD AN OPPORTUNITY TO READ AND REVIEW THIS AGREEMENT. *

I AGREE

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