Are there any physical or mental conditions for which you have received medical treatment or for which you are currently receiving medical treatment? Please include RECENT SURGERIES, PROBLEMATIC OLD INJURIES, any MEDICATIONS you are currently taking and all ALLERGIES, including SPECIAL FOOD REQUIREMENTS?

Cancellation Policy

• To guarantee your place on any tour, a non-refundable deposit is required.
• Payment in full is required when booking is made within 120 days before the departure date. Space is subject to cancellation by Pixelchrome, Inc. if payment is not received when due.
• Final payments are due 90 days before the start of the trip. If you wish to cancel your tour you must send notification in writing to: Pixelchrome, Inc, 605 Rouen Drive, McKinney, TX 75072 or via e-mail to: nicole@pixelchrome.com
• NO REFUND will be provided for a Pixelchrome, Inc Photography Tour/Workshop which has been paid in full within 90 days of departure or anytime after departure.
• We strongly urge you to evaluate your risk and to take out Travel Insurance in the event that bad weather, illness or any other emergency, causes delays or prevents you from reaching your destination during your trip. This should also cover any losses which you may incur, for which Pixelchrome, Inc is not responsible.
• Refunds for services that are voluntarily not used by you cannot be made.

• Each participant must be covered by medical insurance that is valid overseas.
• We strongly urge you to evaluate your risk and to take out Travel Insurance on your trip. It is vital for you to realize that if you experience a delay or find it necessary to cancel or cut short your trip for any reason, you will lose part or the entire sum you have invested in it. Travel insurance helps to minimize the risk of monetary losses you would incur in the event of a delay of your departure due to weather, airline strike, missed connection, etc., your inability to travel for reasons such as illness, injury, unforeseen financial complications and other personal circumstances, or if you were required to cut your trip short for medical or any other reasons. There are restrictions and limitations on any insurance program. For this reason, choose your insurance carefully. Check their policies regarding trip cancellation, baggage, and medical insurance. It is to your advantage to apply for insurance at the earliest possible time, so don't delay in making a decision.
• We recommend Allianz Global Assistance, formerly Access America http://www.allianztravelinsurance.com

Waiver of Liability, Assumption of Risk, and Medical Release

Please read the following information carefully. To participate in a Pixelchrome, Inc photography tour, you are required to read through the following liability waiver, and having done so, acknowledge your full agreement with the electronic signature below. This is required prior to paying your tour/workshop deposit on line. Should you choose to pay your deposit by sending a wire or cheque, you are required to complete and submit this form.  

1. WAIVER OF LIABILITY, COVENANT NOT TO SUE, AND INDEMNIFICATION: In consideration of using the services of Pixelchrome, Inc (“Pixelchrome, Inc”), I do hereby release, waive, and discharge Pixelchrome, Inc and its owners, officers, employees, volunteers, contractors, and agents (collectively, “Pixelchrome, Inc Personnel”), from any and all liability, claims, causes of action, or demands by reason of loss or damage to property (including photographic equipment), personal injury, or death, even where that loss, damage, personal injury, or death, arising from or related to my participation in any Pixelchrome, Inc-related travel or tour activities. I covenant and agree on behalf of myself, my heirs, personal representatives, and assigns, that I will never institute, prosecute, or aid in the institution or prosecution of any demand, claim, or suit against Pixelchrome, Inc and Pixelchrome, Inc Personnel for any destruction, loss, or damage to my property, or for personal injury or death which may occur as a result of my participation in tour activities directed, suggested, or planned by Pixelchrome, Inc. I agree to indemnify Pixelchrome, Inc and Pixelchrome, Inc Personnel from all claims, and to reimburse them for any expenses incurred as a result of my involvement with the tour I have contracted to participate in. I further agree to pay all expenses, including court costs and attorneys’ fees, incurred by Pixelchrome, Inc and Pixelchrome, Inc Personnel in investigating and defending a claim or suit resulting from my participation in any tour activities.
   
   
2. ASSUMPTION OF RISKS: I voluntarily, willingly, and knowingly assume any and all risks, known and unknown, in any way associated with the Pixelchrome, Inc photography tour.
   
   2.1 Foreign Travel. I acknowledge that foreign travel involves risks and hardships, foreseen and unforeseen, including but not limited to, exposure to illness or disease; unsanitary or unsafe food and water; inadequate medical services; poor building and safety standards; and poor health and hygiene standards. Thus, I may be subjected to illness, injury, and even death. I understand these risks and assume them knowingly and willingly.
   
   2.2 Health Advisories. I have been informed that travel to the country or countries contracted for in this tour may be subject to health advisories. Accordingly, I have consulted my health care provider or the Centers for Disease Control and Prevention (CDC) travel advisory website at https://wwwnc.cdc.gov/travel to determine which, if any, immunizations I may need to prevent disease and/or parasitic infection. I knowingly and voluntarily release Pixelchrome, Inc and Pixelchrome, Inc Personnel from any claims I may have for illness, injury, or death due to bacterial, viral, or parasitic infections.
   
   2.3 Physical Activity. I acknowledge that the Pixelchrome, Inc tour may involve walking, climbing, riding animals, swimming, boating, and other physical activities, and that these activities carry the risk of injury, illness, or death. I represent that my physical health is suitable for such an undertaking. I knowingly and voluntarily release Pixelchrome, Inc and Pixelchrome, Inc Personnel from any claims I may have for injuries, illnesses, or adverse health effects due to Pixelchrome, Inc tour activities.
   
   2.4 Photography and Photographic Equipment. I understand that we may encounter conditions beyond Pixelchrome, Inc’s control that make photography difficult or impossible, including but not limited to a lack of quality subject matter, bad weather, and physical conditions which could damage photographic equipment. I acknowledge that have been advised to carry insurance on my equipment. I knowingly and voluntarily release Pixelchrome, Inc and Pixelchrome, Inc Personnel from any claims I may for poor quality photographs and for equipment damage or loss.
   
   2.5 Separation from Tour Group. I understand and acknowledge that there exists the possibility of getting separated from the tour group and lost due to my failure to stay with the tour group. I knowingly and voluntarily release Pixelchrome, Inc and Pixelchrome, Inc Personnel from any claims I may have for injuries or losses due to my failure to stay with the tour group.
   
   
3. MEDICAL RELEASE: I acknowledge and understand that in the event of an illness or injury I may need medical treatment. Pixelchrome, Inc Personnel will not be able to advise me on medical situations, however Pixelchrome, Inc personnel will arrange for me to see a health care provider should the need arise. Pixelchrome, Inc Personnel will not alter the tour itinerary to accommodate delays due to illness or injury, therefore I have been strongly encouraged to purchase travel insurance. I acknowledge and understand that if I become ill or am injured, the tour will continue without me.
   
   3.1 Medical Insurance. I have valid and current medical insurance, including travel coverage adequate to cover injuries or illnesses I may sustain while on the Pixelchrome, Inc tour. I understand that I will be solely responsible for all costs of medical care I may receive overseas.
   
   3.2 Medical Power of Attorney and Consent for Treatment. If I am unable to consent to medical treatment due to physical, or mental incapacity during the Pixelchrome, Inc tour, I appoint Pixelchrome, Inc or Pixelchrome, Inc Personnel as my attorney-in-fact to act for me in my name and on my behalf, and to give any and all consents and authorizations to any medical personnel or institutions pertaining to emergency treatments or procedures they deem necessary or appropriate. This power of attorney shall lapse automatically upon completion of the Pixelchrome, Inc tour and related travel.
   
   3.3 Medical Release of Liability and Indemnification. I hereby release Pixelchrome, Inc and Pixelchrome, Inc Personnel for any and all damages, liability, or costs resulting from the authorization of medical treatment on my behalf under the terms of this consent. I further hold Pixelchrome, Inc and Pixelchrome, Inc Personnel harmless and agree to indemnify Pixelchrome, Inc and Pixelchrome, Inc personnel for any and all costs, damages, or expenses incurred by them as a result of any claim or action filed by any party alleging damages incurred as a result of any medical treatment provided or authorization for treatment provided.
   
   
4. GENERAL ACKNOWLEDGMENTS:
   
   4.1 Promptness. I acknowledge that the tour leaders have planned the Pixelchrome, Inc tour to maximize the number of events and activities for the tour participants, and that such plans are dependent on all of the tour participants being on time for each scheduled event or activity. Accordingly, I promise to be on time for all scheduled activities and understand that my failure to be on time for any activity of the Pixelchrome, Inc tour may result in my being left behind for that activity.
   
   4.2 Itinerary Not A Guarantee. I acknowledge and understand that the time schedules and itinerary provided to me by the tour leaders are only approximations and not guarantees, and that delays or changes in the itinerary may occur due to factors that are beyond the control of the tour leaders, such as late planes, delays caused by other Pixelchrome, Inc participants, or for security reasons.
   
   
5. CHOICE OF LAW: I expressly agree that this document shall be governed by and interpreted in accordance with the laws of the state of Texas, without regard to its conflict of laws principles. Any legal action arising from or related to Pixelchrome, Inc, and this Liability Waiver, Assumption of Risk, and Medical Release Agreement shall be made in Collin County District Court or the United States District Court for the Northern District of Texas. The prevailing party shall be entitled to recover its costs, including reasonable attorneys' fees. In the unlikely event of any controversy or claim arising out of or relating to this Liability Waiver, Assumption of Risk, and Medical Release Agreement, I agree that the maximum amount of recovery to which I will be entitled from Pixelchrome, Inc under any and all circumstances shall not exceed the amount of its fee for professional services, less actual expenses in arranging my travel.
   
   
6. SEVERABILITY: If any portion of this document is held invalid, the balance shall continue in full force and effect.
   
   
7. HEADINGS: The section and other headings of this Agreement are included for purposes of convenience only, and shall not affect the construction or interpretation of any of its provisions.

I HAVE READ THIS WAIVER OF LIABILITY AND INDEMNIFICATION AGREEMENT AND I FULLY UNDERSTAND ITS TERMS. I UNDERSTAND THAT I AM GIVING UP SUBSTANTIAL RIGHTS, INCLUDING MY RIGHT TO SUE. I ACKNOWLEDGE THAT I AM SIGNING THIS AGREEMENT FREELY AND VOLUNTARILY, AND I INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF LIABILITY FOR ANY INJURY RESULTING FROM ORDINARY NEGLIGENCE TO THE GREATEST EXTENT PERMITTED BY LAW IN THE STATE OF TEXAS.