REGISTRATION FORM FOR ENROLL2013
TOUR MEMBER INFORMATION
Full Name of Participant
*
Are you a Skier or Snowboarder?
Skier
Snowboarder
Please select a session
Evolve Chile Session Uno July 23-July 30 2013 ,Price:$ 2349 + Airfare
Evolve Chile Session Dos July 30-Aug 9 2013 ,Price: $ 3249 + Airfare
Evolve Chile Session Tres July 30-Aug 6 2013 ,Price: $ 2349 + Airfare
Evolve Chile Session Cuatro *NEW *@ Termas de Chillan - 16 Days, July 23 - August 6 2013 4,549 + Airfare
Evolve Chile El Combo Session July 23-Aug 9 2013 ,Price: $ 5349+ Airfare
Evolve Chile Session 1 Adults August 9-Aug 16 2013 ,Price: $ 2899 + Airfare
Evolve Chile Session 2 Adults August 16-Aug 23 2013, Price: $ 2899 + Airfare
Gender
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Male
Female
Date of Birth
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Phone:
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Current Address:
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City:
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Province/State:
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Postal/ZIP Code:
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Home Phone:
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Email:
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Passport Number:
Passport Issuing Country:
Family Doctor:
Health Card Number:
PARENTS/LEGAL GUARDIAN INFORMATION
Name:
Current Address:
City:
Province/State:
Postal/ZIP Code:
Home Phone:
Cell Phone:
Work Phone:
Email:
EMERGENCY CONTACT INFORMATION
(Check to use Parent/Guardian Information:
)
Name:
*
Relationship:
*
Home Phone:
*
Cell Phone:
Work Phone:
Email:
*
Would you like to purchase the following additional items:
Travel Insurance
Premier Trip Cancellation, Interruption, Emergency Medical, Baggage & Personal Effects coverage from TIPS Youth Travel Insurance
$ 175
Clothing
Campers who come to Chile are required to purchase or rent an avalanche beacon. You can rent one from Evolve or purchase one on your own
$ 150
Cd/Pictures:
Compilation Picture Album of Camp 2013
$ 150
Enter Promotional code(if any):
You have two choice for payment for your tour:
Pay securely with your Visa/Mastercard .
Pay with Cheque. Please make cheque out to
Evolve Tours, 1759a Avenue Rd, Toronto On, M5M 3Y8
Acknowledgement
1)TRAVEL ARRANGEMENTS AND RULES: I authorize Evolve Tours and its representatives to make any arrangements, accommodations, rules and regulations they may deem advisable, in their discretion, for the well-being and welfare of Evolve Chile Participants. 2)WAIVER: In CONSIDERATION for the ski and snowboard travel program, trip and lessons being offered by 2053720 Ontario Inc. O/A Evolve Tours (hereafter "Evolve"), I hereby represent and warrant that I am the parent or legal guardian for the Evolve Chile and I recognize on his/her behalf (for the purposes hereof, the Participant and I shall be collectively referred to as the "Releasor") that the Evolve Chile in which the Releasor has elected to participate (the "Program") is designed for alpine skiing and snowboarding and therefore carries with it inherent risks including, but not limited to: the hazards of traveling by bus or van, the hazards of skiing, the hazards of snowboarding, the risk of collisions with other skier or snowboarders, the risk of collisions with trees, ski lift poles or other structures, the risk of mechanical breakdown of ski lifts, the risk of falling on ice, snow or exposed ground, the risk of accident or illness on the ski hill, the risk of ski equipment breakdown, the dangers of wild animals, forces of nature, acts of God, extreme weather conditions, physical exertion, evacuation difficulties, and unforeseen delay. The Releasor represents and warrants that he/she is fully informed of these and other risks inherent to the Program. The Releasor further represents and warrants that he/she is voluntarily participating in the Program and hereby assumes all risk of death, injury, illness, or any damage, loss or theft of any personal property. The Releasor hereby releases and discharges Evolve and its officers, directors, shareholders, affiliates, employees, agents, representatives, successors and assigns from any and all claims or causes of action arising out of the Releasor's participation in the Program, except for those claims arising out of Evolves gross negligence or willful misconduct. THE RELEASOR AGREES AND ACKNOWLEDGES THAT HE/SHE HAS CAREFULLY READ THIS WAIVER AND RELEASE AND FULLY UNDERSTANDS THAT IT IS A RELEASE OF ALL LIABILITY. THE RELEASOR HEREBY AFFIRMS THAT HE/SHE HAS SOUGHT OR DECLINED TO SEEK INDEPENDENT LEGAL ADVICE WITH RESPECT TO THIS WAIVER AND RELEASE. IN ADDITION, THE RELEASOR HEREBY WAIVES ANY RIGHT THAT HE/SHE MAY HAVE TO BRING A LEGAL ACTION OR ASSERT A CLAIM FOR DEATH, INJURY OR LOSS OF ANY KIND AGAINST EVOLVE OR ITS AFFILIATES, EMPLOYEES, AGENTS, REPRESENTATIVES, SUCCESSORS AND ASSIGNS FOR NEGLIGENCE OR ARISING OUT OF OR RELATING TO THE RELEASOR'S PARTICIPATION IN THE PROGRAM. THIS WAIVER AND RELEASE SHALL BE BINDING ON THE RELEASOR AND HIS/HER PERSONAL REPRESENTATIVES, HEIRS, EXECUTORS, ADMINISTRATORS AND ASSIGNS.. 3)CANCELLATION (must be by written notice to Evolve Tours): To secure a spot payment must be made in full. Period before 1st departure- cancellation charge: more than 63 days before-third party hold/penalty premiums only; 63 to 35 days before-the greater of hold charges or 60% of total invoiced departure program cost; 34 to 13 days before-90% of total invoiced departure program cost; 12 days before-100% of total invoiced departure program cost. 4)CHANGES IN ITINERARY: I recognize that that the route, schedules, itineraries, amenities and mode of transport may be subject to alteration without prior notice due to local circumstances or events, which may include sickness or mechanical breakdown, flight cancellations, strikes, events emanating from political disputes, entry or border difficulties, climate and other unpredictable or unforeseeable circumstances. The itinerary provided for each program is merely representative of the types of activities contemplated, and the Company is under no contractual obligation to strictly follow it. During the program, if our services in the brochure or website must be altered, in whole or in part, Evolve Tours will use all reasonable efforts to arrange for the supply of comparable accommodations and services. 6)DISMISSAL AND DEPARTURE: The Participant is expected to comply with all Evolve rules and regulations. Evolve reserves the right to dismiss any Participant from the program that staff believes, in their discretion, presents a safety concern or medical risk, is disruptive, or otherwise conducts him or herself in a manner detrimental to the program. If a Participant is dismissed or departs from the Evolve Tours program for any reason, no refunds will be granted. I am responsible for all costs of early departure, whether for medical reasons, dismissal, personal emergencies or otherwise. These costs include, but may not be limited to: medical evacuation; medical treatment; travel fare; and meals, accommodations, compensation and expenses for staff who may accompany the Participant. 8)MEDICAL TREATMENT: I hereby agree that if the Participant is injured or becomes ill during the program, Evolve Tours may, at my cost arrange or supply medical treatment, evacuation or any other emergency services as Evolve Tours deems necessary or appropriate for the Participant's safety and well being. 9)LOST, STOLEN OR DAMAGED PROPERTY: Evolve Tours and its representatives shall not be responsible for the Participant lost, stolen or damaged personal belongings. 10)PHOTO/VIDEO/WRITTEN STATEMENT RELEASE: I hereby authorize and give full consent to Evolve Tours to copyright or use all photographs, videotapes and films in which the Participant appears or any written statements that the Participant makes while enrolled in any and all of their programs and trips. I further agree that Evolve may transfer, use, or cause to be used these photographs, videotapes, films and statements for any and all exhibitions, public displays, publications, commercials, art and advertising purposes without limitation or reservation. 11)SEVERABILITY: In the event that any term or condition contained herein is unenforceable or void by operation of law or as being against public policy or for any other reason, then such term or condition shall be deemed to be severed from this Agreement or amended accordingly only to such extent necessary to allow all remaining Terms and Conditions to survive and continue as binding. 12)SUCCESSORS AND ASSIGNS: These Terms and Conditions shall inure to the benefit of and be binding upon the Company and the Participant and their respective heirs, legal personal representatives, successors and assigns. 13)APPLICABLE LAW AND VENUE: I understand that this application and all aspects of my childs relationship with Evolve Tours will be governed by the laws of the Province of Ontario . Furthermore, any lawsuit or legal proceedings of any kind may only be filed in Toronto , Ontario , Canada . 14)COMPLETION AND PERMISSION TO PARTICIPATE: I have accurately completed the Registration Form and have read, understand and agree to the Terms & Conditions outlined above. I hereby give permission for my child to participate in all Evolve Tours program activities whether conducted by Evolve Tours staff or Evolve Tours outside contractors. This Application shall be binding only when a signed copy, together with an initial monetary deposit, has been received by Evolve Tours and then reviewed and executed by Evolve Tours:
I have read and agree to the Terms and Conditions
Security Code: