ROTARY INTERNATIONAL

youth Exchange
Thf NL'therlands
'V^íc***" '5^0. I5KÜ. 1590,1600. I6IÜ)

INTERCONTINENTAL YOl TH
KXCUANGK

PARENTAL T R A V E L APPROVAL
R E L E A S E AGREEMENT
W e , t h e u n d e r s i g n e d , p a r e n t s o f Nícolc Estephanía S a l a z a r Jnramillo g i v e h i n i / h e r p e r m i s s i o n f o r
travelling outside T h e Netherlands as l o n g as siich travel is approved b y ( h e Netherlands M u l t i
District Y o u t h Exchange I n b o u n d Officer a n d H o s t Rotary C l u b , a n d abides b y t h e olher travel
r e q u i r e m e n t s as stated i n t h e M a n u a l o f P r o c e d u r e .

W e agree t o save a n d h o l d harmless a l l host parents a n d Iheit famiJies, a l l o f l l c e r s a n d m e m b e r s o f

the Netherlands M u l t i District Y o u t h Exchange C o m m i t t e e from ai\ and a l l liability o r obligation
othcrwisc duc undcr the tcrms o f hcr exchange w i t h theNetherlands Rotary M u l t i District 15501610,

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Return origina) to:
Youth Exchange The Netherlands Inbound O f f i c e r See
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Jaarultwlsnling
Rotary iniernalional Youth Exchange Program