_______________________

TO WHOM IT MAY CONCERN:

I, _______________________ of ____________________________, hereby exonerate

_________________________, its officials and employees, of any liability that may arise from

risks associated with my travel to _________________ together with _____________ in

___________________________, this ____________________. This activity shall be regarded as

a personal travel and I shall participate in it with my own accord.

This waiver is executed for whatever legal purpose it may serve.

Very truly yours,

____________________________