OLD - Participation Waiver / Medical Declaration / Dietary Requirements Form

Participant Name*

First NameLast Name

Date of Birth*

Tour*

Which tour are you doing?

Tour Start Date*

Travel Insurance*

Insurance ProviderInsurance Policy Number

PARTIES
This Agreement is entered into between the Tour Operator - Intro Travel Ltd (Company Number 06554003) its successors and assignees (referred to as “we”, “us” or “our”) and you (referred to as “you” or “your”) the individual participating in the tour - including, but not limited to using local transportation, staying in accommodation and participating in the included activities.

ACCEPTANCE
In consideration of us providing the tour to you, you agree to accept the risks of, and waive and release us from any claims arising from, your participation in the tour, in accordance with this Agreement.
You will be deemed to have accepted this Agreement if you confirm your acceptance of this Agreement (whether in writing, orally or electronically (including by typing your name on an electronic device).
By accepting this Agreement, you indicate that you have had sufficient opportunity to read this Agreement and contact us if needed, that you have read, accepted and will comply with this Agreement, and that you are 18 years or older, or have the consent of a legal guardian who is 18 years or older.
You must not accept this Agreement if you are under 18 years of age and do not have the consent of a legal guardian who is 18 years or older. If you do not agree to this Agreement, you must notify us immediately using the contact information below and refrain from accepting this Agreement or participating in any tour provided by us.

RISK
Your participation in the Activities may expose you to the risk of physical harm or personal injury. The risk of physical harm or personal injury may arise from, but is not limited to, third party participants, your physical fitness level, any natural features of the location where the Activities take place (Location) (including logs, trees, rocks, boulders, stones, the weather, any body of water or wildlife animals) or equipment supplied by us). You acknowledge and agree that physical harm or personal injury may arise from you or another party’s acts, omissions or negligence. If you choose to do any optional activities that are not part of the tour itinerary, it is your responsibility to check the safety and accept any risk. To the fullest extent permitted by law, we accept no liability in relation to these additional risks. Any travel advice or recommendation that is offered to you pre or post tour is done so as general advice only. INTRO Travel has not undertaken any formal safety review or diligence check of any such provider, and does not accept any responsibility or liability for the standard of any activities or provisions booked by you with any third-parties.

You understand and voluntarily accept any risk that may arise from your participation in the Activities and/or attendance at the Location.

CODE OF CONDUCT
You agree to comply with our code of conduct at all times, while in the Location (which may include multiple locations) and/or participating in the Activities. You agree:
(a)   not to be under the influence of the excessive consumption of alcohol or prohibited drugs;
(b)   not to engage in reckless, foolish or negligent behaviour, or any other behaviour, which may, in our reasonable opinion, create a risk of injury to you or any third party;
(c)    to remain within the designated boundaries for the nominated Activity;
(d)   to wear any safety gear or equipment that we reasonably require (including life jackets, enclosed shoes, safety devices, hats and/or helmets);
(e)   to notify us if you are harmed or injured, or observe any third party to be harmed or injured; and
(f)    to comply with all of our reasonable instructions (including to leave the Location).
Any failure to comply with our code of conduct or this Agreement will allow us to refuse your participation in the Activities, require you to leave the relevant Location or cancel your tour. You acknowledge and agree that you will not receive a refund for the cancellation of your tour in accordance with this clause (as further set out in our Booking Terms and Conditions).

RELEASE AND INDEMNITY
Despite any provision to the contrary, to the maximum extent permitted by law, you:
(a) understand and voluntarily accept all of the risks; and
(b) hereby indemnify, forever discharge and voluntarily release us (and our contractors, agents and employees) and any person directly or indirectly associated with us, against any and all loss, cost, damage, expense, liability (including liability for the negligence of others), claims, demands and proceedings of any kind, arising from or connected with this Agreement, your participation in the Activities or attendance at the Location, whether those claims were known, or capable of being known, at the date of this Agreement and including personal injury or death or loss or damage to property.
This clause will survive termination of this Agreement.

WARRANTIES
You represent and warrant that:
(a)   there are no legal restrictions preventing you from agreeing to this Agreement;
(b)   the information you provide to us is true, correct and complete;
(c)    you have no physical or medical conditions that prevent you from participating in the Activities or if you have any physical or medical conditions, you have received consent from a medical professional to participate in the Activities;
(d)   you have the required physical health and fitness needed to participate in the Activities; and
(e)   you are 18 years of age or over, or if you are under the age of 18, you have the permission of a parent or guardian to participate in the Activities.
(f)    you have provided us an emergency contact and understand and accept that we will contact them if we ever believe your physical or mental health is at risk and/or we deem it appropriate to protect you, a group member or the general public.
(g)   you have provided us with details for a valid travel insurance policy in your name (including insurance provider and policy number) to cover the duration of your participation on the tour, and give us permission to contact your insurance provider on your behalf should you be unable to contact them yourself when required.

GENERAL CLAUSES
Assignment: We may assign or transfer our rights or obligations under this Agreement without your consent.
Governing law: This Agreement will be governed by and construed in accordance with the laws for the time being in force in the Country of England. The parties irrevocably submit to the exclusive jurisdiction of the courts of England.
Severability: If any part of this Agreement is found to be invalid or of no force or effect under any applicable laws, executive orders or regulations of any government authority having jurisdiction, this Agreement will be construed as though such part had not been inserted herein and the remainder of this Agreement will retain its full force and effect.
Waiver: No waiver by either Party of any provision of this Agreement will amount to a waiver of any other provision of this Agreement unless made in writing and signed by the Party against whom the waiver would have been enforced.
Joint and Several: An obligation or liability on two or more Parties to this Agreement will bind them jointly and severally.

For any questions or notice, please contact us at:
Intro Travel Ltd
124 City Road, London, EC1V 2NX
Phone: 0330 818 9555
Email: hello@introtravel.com

Or contact your Travel Agent.

So that we can ensure your well-being whilst on tour, it's important that you notify us of any medical conditions, disabilities, allergies or dietary requirements you may have.

If you do not inform us of a pre-existing medical condition or allergy and an issue related to it arises whilst you're on tour, we may be required to ask you to leave the tour if we deem your health or safety is at risk. If this happens we will not be liable to compensate or refund you.

The information you provide us will be held in the strictest confidence and will only be used to ensure you are fit to travel, and that we are aware of any special requirements you have, so we can take any necessary steps to make sure you are safe and healthy whilst on tour.

Have you already completed a medical declaration form for your tour?*

YesNo

IMPORTANT: It is a compulsory requirement to complete a medical declaration. Only select Yes if you have previously provided us with your medical information.

If you have new/further information to provide, please complete the form again.

1.) Do you have any medical conditions?*

YesNo

Please state the medical condition(s) and any relevant information you would like us to be aware of:*

IMPORTANT: If you are bringing medication that requires refrigeration, the majority of our accommodations have refrigeration available. However, there may be prolonged periods of travel, activities or certain overnight stops where refrigeration is not available. Therefore, for peace of mind we recommend bringing your own personal cool bag.

Has this condition affected your ability to travel in the past?*

YesNo

Please describe how it has affected you in the past and why you believe you will be ok to travel on this tour now:*

Have you travelled as part of a group tour with this condition in the past?*

YesNo

Have you had any major issues or incidents relating to your condition in the past 12 months?*

YesNo

Please provide details of the issue/incident including date(s) of occurrence:*

2.) Do you have any physical limitations, or require any special assistance?*

YesNo

Please state the physical limitation and any relevant information you would like us to be aware of, or any special assistance you require:*

Has this condition affected your ability to travel in the past?*

YesNo

Please describe how it has affected you in the past and why you believe you will be ok to travel on this tour now:*

Have you travelled as part of a group tour with this condition in the past?*

YesNo

Have you had any major issues or incidents relating to your condition in the past 12 months?*

YesNo

Please provide details of the issue/incident including date(s) of occurrence:*

3.) Do you have any mental health problems, developmental disorders or any other mental health condition?*

YesNo

Please state the mental health problem, developmental disorder or condition you would like us to be aware of:*

Do you take any medication for your condition?*

YesNo

Please state the name of the medication(s) you will be taking:*

Has this condition affected your ability to travel in the past?*

YesNo

Please describe how it has affected you in the past and why you believe you will be ok to travel on this tour now:*

Have you travelled as part of a group tour with this condition in the past?*

YesNo

Have you had any major issues or incidents relating to your condition in the past 12 months?*

YesNo

Please provide details of the issue/incident including date(s) of occurrence:*

4.) Are you pregnant?*

YesNo

IMPORTANT: If you are going to be more than 26 weeks pregnant when you are due to fly, you will be required to complete a Pregnancy Medical Declaration Form with your airline. How many weeks pregnant will you be when you travel?*

5.) Do you have any allergies?*

YesNo

Please state what you are allergic to:*

What type of contact causes a reaction?*

Please describe in detail your reaction to this allergen:*

I.e. Anaphylaxis, vomiting, etc.

Does your allergy require you to carry and travel with an EpiPen?*

YesNo

IMPORTANT: INTRO staff are not authorised to carry EpiPens for customer use. If you require an EpiPen, it is your responsibility to bring your own personal supply.

Please be aware that in some countries it can be difficult to acquire new EpiPens, so you must ensure you have enough to last the duration of your trip if required.

Please state any other allergy medication you will be bringing:*

6.) Do you have any special dietary requirements?*

YesNo

If you have a food intolerance/allergy, please provide the details as requested in question 5.

What is your dietary requirement?*

You can select more than one answer if needed.

Please provide further details if required:

7.) Will you be taking any other medication not already listed whilst on tour?*

YesNo

IMPORTANT: If you are bringing medication that requires refrigeration, the majority of our accommodations have refrigeration available. However, there may be prolonged periods of travel, activities or certain overnight stops where refrigeration is not available. Therefore, for peace of mind we recommend bringing your own personal cool bag.

Please state the name of the other medication(s) you will be taking:*

Please let us know the reason for taking each medication:*

8.) Is there anything else we should be aware of?*

YesNo

Please provide details:*

Signature*

Date of Signature*

Date

Once complete, please return to your Manage My Booking Area and click

"I HAVE SUBMITTED IT" to notify us that you have completed the form.

Or inform your Travel Agent it has been completed.

Participation Waiver Form

Medical Declaration / Dietary Requirements Form