Terms and Conditions for Voyage Participation Informed Consent: Participant desires to participate on a Voyage or to use facilities or equipment situated on property owned or leased by Pacific University or associated with Outdoor Pursuits/Voyages (“OP”), wherever situated on the dates August 20-­‐25 2016. Voyages activities include, but are not limited to, rock climbing, surfing, rafting, biking, kayaking, hiking, camping, backpacking, tubing (collectively “activities”). I acknowledge that participating the trip and any activities, including transportation to and from associated events, involve inherent and other risks, hazards and dangers that can cause or lead to injury, property damage, illness, mental or emotional trauma, disability or even death to participant or others. Among other risks in these activities are associated with or related to these other activities include but are not limited to, travel over land, air, or water; accidents, equipment difficulties, failures, or misuse; remote or extreme weather or environmental conditions; exposure to wildlife or vegetation; slips, trips, or falls; falling objects; lack of timely access to healthcare or emergency assistance; and errors in individual or remote outdoor or mountainous environments, decision-­‐making, travel, equipment, or and misconduct. As a condition of participation in any activities with Voyages, I, on behalf of myself and my heirs and assigns, expressly acknowledge and agree: •
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Participation is voluntary and no inducements, representations, or guarantees have been made regarding or relating to the activities. The trip involves risks and dangers that may pose or cause the injury, harm, disability, death, or damages listed above. I am fully aware of any and all risks and dangers connected with the trip and activities, including, but not limited to, bruising, burns, cuts, scrapes, sprains, strains, irritation, bleeding, pain, soreness, contusions soft tissue injuries, fractures, head injury, spinal injury, weakness, disability, death, or other injuries or illness. Further, I am aware that there may be risks and dangers unknown to me that may exist or arise before, during or after participation in the activities. I am responsible for my safety and will not engage in any conduct or behavior that will endanger me or anyone else. I will use equipment in a safe manner and in accordance with manufacturer’s instructions and those will follow all directions, guidelines, and any rules of any Voyage Instructor. I am physically and mentally fit to a level appropriate to participate, and have alerted Voyages to my medical history before participation. I will engage in activities for which I have adequate physical capacity. If I am unable to participate, I will notify Voyages immediately. I shall refrain from use of tobacco, alcohol or illegal drugs while participating in any Voyages led activity. I expressly warrant and represent that I currently am and at all times during which I participate in activities with Voyages shall be covered by health and accident insurance providing benefits sufficient to cover risks or injury or illness associated with the activities in which I am participating. •
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In case of emergency, accident, or illness, I hereby grant Pacific University and Voyages, including all employees, students, and volunteers, to provide first aid or contact emergency responders and authorize treatment by a professional medical personnel and admission to a hospital or other healthcare facility. I further agree to be the party responsible for all medical expenses, including emergency transport. I acknowledge and agree that my signature below constitutes voluntary consent to engage in transactions related to the Pacific University Outdoor Pursuits and Voyages programs by electronic means and your use of an electronic signature below legally binds you in the same manner as if you had manually signed this document. Medical History: By signing below, you hereby acknowledge and agree that all information provided is correct and complete. You also agree that Pacific University Outdoor Pursuits and Voyage staff are authorized to treat you while on a program trip and that you will be financially responsible for all fees incurred in your medical emergency, including treatment and evacuation. You acknowledge and agree that you signature waives your rights under the Federal Educational Records Privacy Act. I acknowledge and agree that my signature below constitutes voluntary consent to engage in transactions related to the Pacific University Outdoor Pursuits and Voyages programs by electronic means and your use of an electronic signature below legally binds you in the same manner as if you had manually signed this document. Registration Agreement: I authorize Pacific University to charge my student account the full trip fee cost for the Voyages Course. The full trip fee for the Voyages Course will consist of the initial cost of the trip ($375-­‐$625 depending trip you are on), and the cost of any rental items that you need (i.e. $20 for a sleeping bag, $10 for clothing items like fleece shirts or rain jackets). We will not charge your student account the rental items until you actually use these items on the trip. A non-­‐refundable fee of $75 will be assessed to your student account once you submit this online registration form. By submitting this form, you authorize Pacific University to use Financial Aid funds (which can include Title IV loans or grants, scholarships, or other institutional, federal, or state funds) to pay any non-­‐standard charges assessed to my student account. These charges may include, but are not limited to, the following: book charges, library fines, parking fees and/or permits, medical charges, late fees and/or installment plan fees, printing fees, music costume and/or lesson fees, equipment rental fee, Voyages trips. I understand that this fee of $75 is non-­‐refundable and that I must cancel in writing by emailing pacificuvoyages@gmail.com (by July 25, 2016) in order to avoid the full fee amount being charged to my student account. I authorize Pacific University to charge my student account the full trip fee cost for the Voyages trip. You acknowledge and agree that your signature, typed below constitutes voluntary consent to engage in transactions related to the Pacific University Outdoor Pursuits and Voyages programs by electronic means and your use of an electronic signature below legally binds you in the same manner as if you had manually signed this document.