Registration Confirmation For FirstName LastName

Name:                  LastName, FirstName
Address:               AddressLine1 AddressLine2
City, State & Zip:  City, State  ZipCode
Home Phone:       HomePhone
Work Phone:        WorkPhone
E-mail Address:    EmailAddress
Birthday:              BirthdayMonth BirthdayDay, BirthdayYear
Fitness Level:       FitnessLevel
T-shirt Size:          TshirtSize
Trip:                     Trip
Emergency Name:    EmergencyName
Emergency Phone:   EmergencyPhoneNumber
Vegetarian Meals:    Vegetarian
Referred By:  ReferredBy
Nickname:     Nickname
Comments:    Comments

Print this form (portrait style), read it, sign it, mail it & your check to:

Make checks payable to:
Adventure Trekkers, 905  S. Gaylord St., Denver, CO 80209

NO PAYMENT REQUIRED TO RESERVE A SPACE    (Past Attendees receive $50 off all prices.)       

For all trips except the MMBA Full Payment is due 60 Day Prior to Trip Departure Date.          

MMBA Payment Plan:  $275 if paid before Feb. 1, 2008;  $300 if paid by March 31, 2008;  $325 if paid by April 30, 2008; $350 if paid after May 1, 2008  (T-shirts not guaranteed for late sign ups.)

I AGREE TO THE FOLLOWING AS A CONDITION OF PARTICIPATION: I will provide and wear a helmet. I also understand that bicycling, camping and other outdoor activities on an Adventure Trekkers trip 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 agencies known or unknown. I acknowledge that the enjoyment and excitement of the trip is derived in part from the inherent risks incurred by trip activities beyond the accepted safety of life at home or work, and that these inherent risks contribute to such enjoyment and excitement, being a reason for my participation. I am aware that there are No Guides and None of the rides or hikes are guided on the MMBA. Where as Rick or Josh may accompany you and others on a hike or ride they are not qualified to be your guide. All other trips are fully Guided.  I am aware that medical services may not be readily available or accessible during the trip. I give my consent for medical release should treatment for an accident or illness be required during the trip. I agree that Adventure Trekkers, Inc. and its agents shall not be responsible for, or legally liable for, any losses of property or personal injury suffered in conjunction with any activities on this trip. I have and do hereby release and discharge Adventure Trekkers, Inc. and its agents from all actions, claims or demands resulting from my participation. 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 also give my personal consent to use photographs taken on the trip. No refund will be returned if the cancellation is received less than 30 days prior to the trip start date.  No spaces will be guaranteed with out full payment.  You must be 21 years or older to attend or be accompanied by a parent.
________________________________
Signature                                                                                                                            Date

Please direct questions to:
Denver Contact: Rick Pratt (303) 887-3717    RPratt@AdventureTrekkers.com

Seattle Contact: Josh Gerak
                        
JoshGerak@gmail.com