Exotic Birding Registration Form

Name of Tour Start Date End Date*
_______________________________________________________ _______________ _______________

PARTICIPANT INFORMATION

Participant Name: ______________________________________________________________________

Additional Participant/Companion: _______________________________________________________

Birding Skill Level (N=None, B=Beginner, I=Intermediate, A=Adv): Participant ____ Companion ____

Address: ______________________________________________________________________________

______________________________________________________________________________________

Contact Info:  Home Phone (____)_________ Work Phone (____)_________Fax (____)___________

Email: ________________________________ Do Not Include Email on Participant List ___

ACCOMMODATION PREFERENCE

___ Double occupancy. Name of desired roommate: ________________________________________

___ Please arrange a roommate. I'll pay single supplement if none available. Gender __ I smoke __

___ I want a single room when available. A single occupancy supplement will be assessed.

Separate Beds (Queen or Twin) ________ Shared Bed (King, Queen, or Double) ________
*King beds often unavailable. Queen/Double sometimes unavailable or may be 2 twins pushed together.

PAYMENT ARRANGEMENTS

Deposit Amount Enclosed ($300 for Central America, $500 for South America): $_________

Payment method:                Check _____     Visa ______     Mastercard _____

Credit Card Number: ________________________________ Expiration: __________

Cardholder Signature: ________________________________________________________

LIABILITY LIMITS

By registering for an Exotic Birding tour or workshop, each participant acknowledges that he/she is aware that travel organized or conducted by Exotic Birding LLC involves various risks and dangers including but not limited to the hazards of traveling in foreign countries and wilderness areas, travel by air, train, bus or other conveyances, tropical diseases, venomous animals, inadequate access to appropriate medical care, extreme weather conditions, geological events, exposure to high altitudes, and political events or instabilities.

The undersigned agrees to assume all such risks and expressly releases Exotic Birding LLC, its officers, agents, contractors, tour leaders, and other representatives to include any sponsoring organization and its representatives (hereinafter TOUR OPERATOR) from any liability, damage claims, costs, and actions pertaining to any and all risks, accidents, deaths, injuries, illnesses, property damage or loss, delays, inconveniences, or other irregularities that may occur for any reason whatever directly or indirectly in conjunction with or arising from the tour or workshop.

The undersigned acknowledges that the delivery and success of Exotic Birding tours and workshops as advertised is dependent on service providers such as guides, instructors, hotels, and restaurants providing acceptable services and agrees not to hold TOUR OPERATOR liable should any such service provider fail to provide services as advertised or anticipated.

The undersigned acknowledges and accepts that TOUR OPERATOR does not warrant in any fashion the success of the tour in terms of enjoyment, in terms of how many or which birds or other wildlife are actually seen or photographed by any participant on tour, or in any other way.

The undersigned agrees to conduct himself/herself in a civil manner toward other participants and TOUR OPERATOR. Further, the understand agrees that TOUR OPERATOR has the authority to eject anyone from the tour for egregious, threatening, belligerent, unruly, disruptive, or criminal behavior without refund in the event such behavior persists following one or more warnings.

The undersigned understands that this document, once signed, shall serve as an assumption of risk, waiver, indemnity, and release by all signatories, their heirs, all members of their families including any minors accompanying the tour, executors, administrators, and any other representatives of the signatories. The undersigned further understands that the terms of this document are contractual and not merely advisory in nature. All legal matters relative to these terms and conditions as they affect Exotic Birding LLC shall be directed to and litigated only through the legal system in Arapahoe County, in the State of Colorado, in The U.S.A. All legal matters relative to these terms and conditions as they affect any sponsoring organization shall be directed to and litigated only through the legal system designated by said sponsoring organization.

SIGNATURE AND SUBMISSION

IMPORTANT: By signing this agreement, each signatory acknowledges having read, understood, and accepted all terms stated above and all policies of Exotic Birding LLC regarding payments, refunds, cancellations, conduct of tours, and all other matters as stated on its website at http://exoticbirding.com/home/policies.html or obtainable by contacting Exotic Birding at 877-247-3371.

Signature: ________________________________________________________________________________

Signature: ________________________________________________________________________________

Please mail your signed registration form and deposit(s) to:

                Exotic Birding LLC ; 2727 Nelson Rd Suite E207 ; Longmont, Colorado 80503 USA