TOTAL DUE: $325 per Safari Participant or $495
for two Safari Participants sharing one cabin
Please make your check payable to The Darkroom and mail
with this Registration and a copy of the completed "Assumption
of Risk,Waiver and Release of Liability"for each Safari
Participant.
Directions and a list of recommended equipment and supplies will be sent to you upon receipt of your completed registration packet and payment.
Cancellation Policy: If you need to withdraw from the Photo Safari after your payment has been made, The Darkroom will refund your payment, less a $25 non-refundable fee, within ten days of receipt of your written notification by either mail or email (email address: safari@darkroomz.com), providing it is received on or before the "Deadline for Refundable Cancellation". If, for whatever reason, any such notification is received after the "Deadline for Refundable Cancellation", your payment, less the $25 non-refundable portion, may be applied toward other activities offered by The Darkroom (photo safari, class, workshop, lab time, etc.).
If it is necessary for The Darkroom to cancel the Photo Safari, all registered participants will be informed as soon as possible, and you will receive a full refund of all fees paid. Notification of cancellation due to insufficient registration will be made at least ten days prior to the beginning date of the Photo Safari. The Darkroom will not be responsible for any losses you may incur related to cancellation.
WHAT IS INCLUDED: YOUR FAMILY/FRIENDS ARE WELCOME TO SHARE YOUR ACCOMODATIONS AS YOUR GUESTS (a small extra fee is assessed for guests over the basic two-person occupancy rate). ACCOMODATIONS ARE IN 1-ROOM KOA CABINS WITH 1 DOUBLE BED AND 2 BUNKS (SLEEPS A TOTAL OF 4 PEOPLE). CLEAN, HEATED, COMMUNITY RESTROOMS WITH HOT SHOWERS ARE AVAILABLE ON THE GROUNDS, AS WELL AS A COVERED, OUTDOOR KITCHEN. These accomodations have been dubbed "luxury camping" by former participants. You will need to bring your own bedding and towels. IF YOU NEED A LARGER CABIN OR WISH TO BRING YOUR OWN RV, SPECIAL ARRANGEMENTS CAN BE MADE BY NOTIFYING THE DARKROOM AT THE TIME OF YOUR SAFARI REGISTRATION.
REGISTRATION INCLUDES ACCOMODATIONS FOR TWO NIGHTS, ORIENTATION AND TECHNIQUES DISCUSSION AROUND THE CAMPFIRE ON FRIDAY NIGHT, CONTINENTAL BREAKFAST ON SATURDAY MORNING AND ALL FIELD INSTRUCTION ON SATURDAY AND SUNDAY. We will host a pot luck dinner on Saturday night.
TOTAL AMOUNT ENCLOSED FOR _______ SAFARI PARTICIPANT(S): $_____________
SAFARI PARTICIPANT(S) NAME(S)____________________________________________________________________
ADDRESS__________________________________________________________________________________________
PHONE_______________________________day eve
EMAIL________________________________________________________________
TOTAL NUMBER OF PEOPLE IN YOUR PARTY______
Please indicate names of non-participant adults and number of
minors:
_________________________________________________________________________________________________
Please complete the following information if registrant is under 18 years of age:
EMERGENCY PHONE (weekends/evenings)______________________________
MEDICAL PLAN Name___________________________________ID Number_____________________
PHYSICIAN_____________________________________________PHONE_______________________
Each Safari participant (or parent/guardian if Safari participant is a minor) must read, sign and return an Assumption of Risk, Waiver and Release of Liability form below.
Please read, sign and return with your registration packet:
ASSUMPTION OF RISK, WAIVER AND RELEASE OF LIABILITY, INCLUDING NEGLIGENCE
I, (please print)_________________________________________, agree to each and all of the following in connection with my participation in the photography workshop, North Coast Photo Safari, conducted by The Darkroom, Oct. 6 - 8, 2006 at Manchester Beach, California and surrounding areas:
1) I am a healthy adult, voluntarily participating in this photography
workshop and I assume all risks of illness, injury, death, damage
and/or loss to myself or my property that might result.
2) On behalf of myself and my personal representatives, heirs,
executors, administrators, agents and assigns, I hereby release
and discharge in advance J. Michael (Jerry) Ott, Linda Ott and
The Darkroom (and its owners, employees, instructors, agents,
representatives and assigns) from any and all liability, even
if that liability arises out of negligence and/or carelessness
on the part of the persons or entities mentioned above.
3) My assumption of risk, waiver and release of liability, including
negligence, encompasses, but is not limited to: death, bodily
injury, illness, damage, theft and/or loss of personal property
during said workshop which occurs as a result of anything during
the entire workshop. The following are some, but not all, of the
possibilities:
a) traversing uneven ground, with or without
photographic equipment in order to access off-road photography
sites;
b) utilizing narrow vehicle pullouts along
the coastal highways to access roadside overviews for photographic
or other purposes;
c) transportation between the Manchester
Beach KOA campground and the various photography sites via carpool
with other participants;
d) natural hazards, such as, but not limited
to, steep cliffs, hazardous footing, wet rocks and driftwood,
dangerous ocean undertow, "sleeper waves" and/or poison
oak;
e) negligent instruction and/or supervision
by any of the persons involved in the workshop on behalf of The
Darkroom.
Consent of Parent or Legal Guardian (if registrant is under 18 years of age):
I certify 1) that I am the parent or legal guardian of (minor
child)_______________________________, 2) that my child is
healthy and in adequate physical condition to participate in the
activities involved in the class(es), workshop(s) and/or field
outing(s) named on this course registration,
3) that my child is a voluntary participant in said activities,
4) that I give my permission for him/her to participate in said
class(es), workshop(s) and/or field outing(s),
5) that my child and I assume all risks of illness, bodily injury,
death, damage, theft and/or loss to my child/ward or personal
property that might result
and 6) that I hereby execute on his/her behalf the Assumption
of Risk, Waiver and Release of Liability, Including Negligence.
In the event of an emergency, I authorize The Darkroom and its owners, employees, instructors, agents, representatives and assigns to secure from any licensed hospital, physician, and/or medical personnel any treatment deemed necessary for my minor child's/ward's immediate care and agree that I will be responsible for payment of any and all medical services rendered.
I have carefully read this Assumption of Risk, Waiver and Release of Liability, Including Negligence. I am aware that both predictable and unpredictable risks are involved during the classes, workshops and field outings conducted on behalf of The Darkroom. I hereby agree to assume all of those risks and to release and hold harmless all of the persons or entities mentioned above who through negligence or carelessness would otherwise be liable to me or to my heirs or assigns for damages, or to my minor child or to my child's heirs or assigns.
Signed__________________________________
Dated___________________________