Hold Harmless and Assumption of Risk
IN CONSIDERATION of my participation in a trip with; “COSTA RICA HERPING ADVENTURES, LLC”. I hereby agree to the following: As the trip name implies, this trip may be dangerous and hazardous to my health and safety. It is the common goal of this trip to find, capture and photograph reptiles. It is highly probable that we shall encounter venomous snakes, which we may collect for study and photographing. I hereby acknowledge these activities are dangerous to me even if I personally don’t collect these animals. Just being in the Rain Forest and in the proximity of the animal or any other person collecting these animals could be extremely hazardous. It is possible we may encounter large crocodiles or other dangerous animals, insects or plants. I hereby acknowledge that I will be in several forms of public and private transportation that may be hazardous to me. I acknowledge that I will be in rented cars driven by any member of our group. I may be expected to drive as a member of this group. I acknowledge that I may be exposed to extreme weather conditions, earthquakes, civil disturbances and unrest. I may be subject to physical exertion and sickness. I hereby acknowledge that I accept and assume these and all other possible inherent risks associated with a trip of this nature. I HEREBY RELEASE AND HOLD HARMLESS COSTA RICA HERPING ADVENTURES, LLC., its owners, stockholders, heirs or assigns. I further release and indemnify Costa Rica Herping Adventures, LLC, its owners, stockholders, heirs or assigns of any and all liability for any and all damages, loss, injuries or death, including negligence on the part of Costa Rica Herping Adventures, LLC its owners, stockholders, heirs or assigns. This agreement is binding on me, my personal representatives, heirs, assigns and all kin. I DO AGREE to abide by all the rules of the group leader and acknowledge that the rules will be made as the situation may arise. If, I fail to obey the orders of the group leader, I may be asked to leave the group and agree to do so of my own accord. No refund of any kind will be due from Costa Rica Herping Adventures, LLC. I hereby certify that I am 18 years of age or older. This agreement extends to any and all future trips that I may take with Costa Rica Herping Adventures, LLC. I agree that any and all photographs taken by myself on this trip that I share with anyone on this trip may be used in any form by fellow members of the trip and by Costa Rica Herping Adventures, LLC. I hereby certify that to the best of my knowledge I am in good health and physical able to handle the demands of walking up mountains trails for at least 3 to 4 hours on hikes. I hereby acknowledge that I have read and agree to the above Hold Harmless and Assumption of Risk.
Signature of Applicant________________________________________ Date: ____________________
Name (Print Exactly as on Passport)______________________________ DOB__________Passport#________________
Address__________________________________City________________ State____Zip ___________
Phone__________________Work Phone____________________Cell Phone_____________________
Email address __________________________________________________________________
In case of emergency notify ____________________________________Relationship________________
Home phone ______________________Work phone __________________ Cell __________________
To reserve a spot for a trip please call Jim Kavney at 305.393.2732 for mailing instructions.