Adventure Trekkers Online Registration Form First Name *Last Name *Email Address *Street Address *0 / 60Apartment, suite, etc0 / 15City *State *StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingZIP / Postal Code *Cell Phone *Birthday Date *Fitness Level *Couch PotatoStill TryinGonzo WannabeTruly GonzoT Shirt Size *SmallMediumLargeX LargeXX LargeALL SHIRT SIZES WILL BE: Men's for Men, Women's sizes & cuts for Women, & Youth sizes for Kids (Unless you specify Otherwise.) ** NO SIZE CHANGES AFTER YOU ARRIVE IN MOAB **Trip Location *MMBA - Moab Mtn Bike AdventureARBA - Anazazi Ruin Bike AdventureUMBA - Ultimate Mtn Bike AdventureCustom AdventureVegetarian Meals *YesNoReferred By *Nickname *When do you plan to arrive at camp?SelectMorningNoonEveningNightDate *Emergency Contact Name *Name of Emergency Contact0 / 60Emergency Phone Number *Comments Or NotesFood Allergies, Bug or Plant Allergies, Heart Conditions, Seizures, Diabetes, and other Health concerns MUST be mentioned here0 / 120 WAIVER, RELEASE AND HOLD HARMLESS AGREEMENT ADVENTURE TREKKERS, INC. I, the person filling out this form would like to: A. Participate in the following activities: bicycle riding including, but not limited to mountain biking, camping, hiking, rock climbing and/or bouldering, rappelling abseiling, canyoneering and/or the outdoor activities, other physical exercises and stretching, and any ancillary activities related thereto Activities, B. Use any equipment supplied by, procured through, and/or maintained and/or repaired by Adventure Trekkers, Inc., a Colorado corporation Adventure Trekkers, and/or Adventure Trekkers` board members, shareholders, officers, employees, agents, independent contractors, instructors and/or members and friends. C. Participate in other related Adventure Trekkers activities collectively, the AT Activities, which AT Activities are sponsored by, or is in association with, Adventure Trekkers. As more fully set forth below, I understand that in consideration of my and/or my child`s participating in the AT Activities, I am waiving and releasing on my behalf as well as on behalf of my child, as the case may be and on behalf of our respective estates, successors and assigns, all claims for injuries and/or death arising out of, or in any way connected to the AT Activities that might be sustained by me or my child as the case may be. The terms I, me and my used below refers to any adult or child participant, participant as well as any such child`s parents/guardians. In consideration of my or my child`s participation in the AT Activities, by signing this Waiver, Release and Hold Harmless Agreement, I, on my behalf as well as on behalf of my child, as the case may be and on behalf of our respective estates, successors and assigns, agree as follows: 1. By participating in the AT Activities, I acknowledge and agree that: (a.) there are certain risks of physical injury, and I agree to assume for myself or my child, as the case may be the full risk of any injuries including death, damages or loss which I may suffer as a result of participating, in any manner, in any and all activities connected with or associated with the AT Activities, the use of my own equipment or equipment provided to me by Adventure Trekkers or any person or any other ancillary activities related thereto; (b.) the AT Activities and all athletic activities involving strenuous exertion, potential body contact, or potential contact with bicycles, rock climbing and/or canyoneering and/or other physical equipment of any kind like the AT Activities are hazardous activities, are physically challenging and contain inherent risks of illness, injury or death, which may be caused by the negligence of others, forces of nature, consumption of alcoholic beverages or other intoxicating substances, or other agencies known or unknown; (c.) Adventure Trekkers and its agents or anyone that may be leading an AT Activity or anyone else participating, shall not be responsible for, or legally liable for, any losses of property, personal injury, or death suffered in conjunction with any Adventure Trekkers trip or AT Activity; (d.) not all rides, climbs, canyons hikes, canyoneering will have leaders or guides; and that I am and will be responsible for my own route finding; safety, and any and all decisions while participating in an AT Activity;(e.) the Released Parties defined below are not responsible for my or my child`s contraction of infectious diseases including [but not limited to] any and all currently known or unknown strains of the virus commonly known as COVID-19, that I may contract prior to, during, or after any AT Activities. 2. To the extent permitted by law, I hereby waive, discharge, release, and relinquish any and all claims that I may have as a result of participating in the AT Activities against Adventure Trekkers, its board members, shareholders, officers, employees, agents, independent contractors, instructors and/or members, licensees, visitors, guests and any and all other persons or entities including, but not limited to, Joshua (Josh) Gerak, Richard (Rick) Pratt, and any and all trustees, board members, owner(s), manager(s) and/or operator(s) (and their respective employees and agents) of any real property upon or about which the AT Activities take place, as well as any other AT Activities participants other than myself, whether paid or unpaid by Adventure Trekkers or others all of the above-listed parties and entities are hereinafter referred to as the Released Parties, even if such Released Parties are (or might be) directly or indirectly responsible in whole or in part, for (a) any injuries including death, (b) my or my child`s contraction of infectious diseases including but not limited to any and all currently known or unknown strains of the virus commonly known as COVID-19, before, during or after any AT Activities, (c) property damage or other losses that I (or my child) might suffer or incur while participating in, or in any way connected to the AT Activities, or in connection with the use of any equipment in connection therewith supplied by any of the Released Parties. 3. I further assume responsibility for examination and approval of all equipment furnished by all others and for installation of equipment used by me and/or my child. I acknowledge and accept responsibility for the risks including but not limited to, falls, poor decisions, inattention of belayers, other participants, AT Activities leaders, or any other of the Released Parties, failure of equipment, misuse of equipment, falling rocks, flash floods, weather or any usual, unusual or unique accident or incident. I accept responsibility for my own medical care, including but not limited to first aid, evacuation, and hospitalization. I give my consent for necessary medical care should treatment for an accident or illness be required during or after the AT Activities. I accept that this release of liability applies to loss, damages, severe injury, or death as a result of negligence. I understand I am solely responsible for my personal safety and wellbeing and shall take all precautions necessary while engaged in all AT Activities. 4. I also give my personal consent for Adventure Trekkers to use photographs that contain my image that are captured before, during and after the AT Activities. No refund will be returned if the cancellation is received less than 30 days prior to the AT Activities trip start date. No spaces will be guaranteed without full payment. I understand that this release of liability shall apply to all of my underage children for which I am the parent or guardian. You must be 21 years or older to attend or be accompanied by a parent. No pets are permitted on any AT activity or trip. Further, I will not initiate any lawsuit, court action, legal proceeding, or be a party to, join in, or assist in the prosecution of Released Parties. I waive my insurer`s right to make a claim against any of the Released Parties. I agree for myself and my family and heirs to release any of the Released Parties from liability. I have and do hereby release and discharge any and all of the Released Parties from all actions, claims, or demands resulting from my participation in the AT Activities. I agree that any arbitration and/or litigation that may arise will be settled in the State of Colorado and according to the laws of that state.I acknowledge and agree that I understand the nature of the AT Activities in which I am (or my child is) participating, and have read and fully understand this Waiver, Release and Hold Harmless Agreement. By adding/typing your name in the Signature Box below, you acknowledge that you have read the above Terms; Conditions Liability Release and agree to all paragraphs. The exact language will be printed for your record with your Registration Form at the next step in the registration process. Once you have made payment through PayPal (or sent us a check) your registration will be complete, and you will be added to the list of participants. Consent *AGREE To RELEASE AND HOLD HARMLESS AGREEMENTName *Signature NameDate * Sign FormPlease do not fill in this field.