Nicaragua
Trip Reservation Form
February
10-17, 2007
Name: ...
Address:
..
Phone number: .
Deposit Amount Enclosed: .
Names of individuals in party: ..
Health or Diet Restrictions:
Please sign to signify agreement with cancellation policy:
. Date:
WAIVER OF ALL CLAIMS,
RELEASE OF LIABILITY and ASSUMPTION OF RISKS
I understand that during the course of my trip with Cascadia Research and Puesta del Sol (hereafter referred to as the Companies) certain risks and dangers may occur, including but not limited to the hazards of going out on the ocean, operating near whales, being in a remote area, traveling in a third-world country, accident or illness in remote places without medical facilities, and the forces of nature. In consideration of the Companies accepting my application to go on a trip, I waive any and all claims I have or that I may have in the future against the Companies and their officers, employees, guides, agents or representatives (collectively their staff), and release the Companies and their staff from all liability and agree not to sue them for any injury, death, property damage or loss sustained by me as a result of my participation in a trip with the Companies and their staff. In entering into this agreement, I am not relying on any inducements made by the Companies or their staff to encourage me to go on a trip.
I confirm that I have read
and understand this agreement prior to signing it and agree that this agreement
will be binding upon my heirs, next of kin, executors, administrators and
successors.
Name of
participant:__________________Signature:_________________________ Date:_______
Name
of participant:__________________Signature:_________________________
Date:_______
Return this form to:
Cascadia Research
218
½ West Fourth Avenue, Olympia, WA 98501
For
additional questions about these trips email John Calambokidis who will be the
trip leader (click to send email message) Calambokidis@CascadiaResearch.org