Tour Waiver Form

Client Intake & Waiver Form

All information is held strictest confidence. At no given point is information disclosed or shared without client’s written consent. You may choose to skip answering any question you feel impinges on personal information you do not wish to disclose.

Full Name*

First NameMiddle NameLast Name

Tour Date*

MonthDayYear

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Birth Date*

MonthDayYear

Phone Number*

Phone number type*

E-mail*

Emergency Contact*

Phone Number*

Relationship to emergency contact*

In order to create the best customized experience possible, please provide the following information.

1. Have you ever participated in a wildlife tour?

YesNo

If yes, please list where you went and identify tour company used.

2. Do you have any medical issues or allergies we should know about?*

YesNo

If yes, please list

3. Are you currently on, or have you recently taken, any medication(s)?*

YesNo

If yes, please list medications

4. Are you able and willing to hike (up to 1 mile) or would you prefer to photograph from the vehicle?*

I am comfortable hikingPhotograph from vehicle

5. Are you interested in receiving one-on-one photography instruction? Will you need to rent cameras and/or equipment?

One-on-one photography instructionCamera rental neededEquipment rental needed

6. Are you interested in information about photography vests, portable tripods, and other equipment that will make your photography experience even better?

YesNo

7. While we cannot make any guarantees of your experience, we would love to hear what you expect of your Rob's Wildlife experience. Are there particular sights, animals, etc you want to have so we can do our best to customize your experience.

8. During the course of your wildlife experience, digital recording (photos, videos, and/or live streaming) may occur. Do we have your consent to include you in still image or video in possible future advertisements?*

Yes, I consent to allow Rob's Wildlife LLC to use digital recording of my participation.I do NOT allow Rob's Wildlife LLC to use digital recording of my participation.

WAIVER OF LIABILITY AND INFORMED CONSENT RELEASE

I hereby certify that I am voluntarily participating in the experience provided to me by Robs Wildlife LLC. I understand that Robs Wildlife, LLC is not obligated to provide this experience to me and I am participating in the experience voluntarily.

Although the experience is considered to be safe, I acknowledge and understand that there may be risk associated with my participation. I understand that my tour guide(s) are professionals and that they are knowledgeable and experienced. I agree to follow their guidance and instruction especially when interacting with wildlife, nature, equipment, and all other properties. I understand that the results of this experience are not guaranteed. I acknowledge that I am not relying on any representations made to me with respect to any possible results of my participation in this experience.

I hereby release and discharge from all liability, and indemnify, Robs Wildlife, LLC, its members, managers, officers, instructors, independent contractors, and employees from and against any and all liabilities, losses, claims, demands, damages, actions, expenses, including attorney fees and costs, whether in contract, tort, negligence, product liability, or otherwise, with respect to injury, loss, death, or damage to my person or property, arising out of, incidental to, or in connection with my participation in this experience, regardless of whether said injury, loss, death or damage may be due to any act or failure to act, or any negligence of any of the aforesaid. I acknowledge and agree that this consent release shall be binding upon me and my heirs, executors, administrators, assigns. The provisions of this release are severable, and should any provision here of be void, voidable, unenforceable or invalid, such void, voidable, unenforceable or invalid provision shall not affect the other provisions of this Agreement.

I agree that I have been given an opportunity to ask questions about the experience and I have provided sufficient information to give my informed consent. I give permission for the tour guide(s) to direct and give me information needed to have a safe and exciting journey.

Any claim arising out of or relating to this release shall be settled by binding arbitration conducted by one arbitrator in Salt Lake City, Utah, in accordance with the Commercial Arbitration Rules of the American Arbitration Association, and judgment upon the award rendered by the arbitrator may be entered in any court having jurisdiction thereof. The parties shall pay their own attorney's fees and costs incurred in arbitration.

By my electronic signature below, I agree that I have read and understand this release form and consent to its terms.

Signature*

Sign by using a touch tablet/screen or left click and hold as you sign with your mouse.

Signed this date