Participant Registration Form
~Austin Pedal & Pub Adventure~
March 15-22, 2014
Cost: $989 (plus airfare & bicycle rental/carry on)
Participant Information
First Name: _______________________
Last Name: ______________________________ MI: _____
Address: _________________________________________________________________
City: ________________________
State: _____
Phone (work): _________________
Zip: ____________
Phone (home): _________________ Phone (cell): ___________________
e-mail: _________________________________________
DOB: ___/___/_______
Gender: M F
Name as it appears on Passport: __________________________________________________
Are you a UWSP Alum or UWSP Student?: ___________________
Roommate Request: ________________________________
Emergency Contact (someone not traveling with you): __________________________
Relationship: _____________________________________
Registration closes
December 20th, 2013
Emergency Phone: _________________________________
T-shirt or Jersey size:
XS
S
M
L
XL
XXL
Health Information
I am in good general physical health
I have the following medical physical conditions that may limit my activities:
___________________________________________________________________
___________________________________________________________________
Please list any allergies you may have:
___________________________________________________________________
Dietary or other personal needs or restrictions:
___________________________________________________________________
*Every effort will be made to accommodate special needs/ requests but cannot be guaranteed.
How did you hear about UWSP Adventure Tours? Please circle one or write in source:
Article in local paper
Facebook Ad
Email from UWSP Adventure Tours
Faculty - Campus Announcements
Mailing from UWSP Adventure Tours
Presentation
UWSP Alumni Association
Student - Campus Announcements
Web Search
Word of Mouth
Magazine Ad
Program Manager
A specific person or other: _________________________________________________________________
Please see page 2
Terms and Conditions
Deposit and Payment: A $200 per person deposit is required to confirm your reservation. The deposit will be
applied towards the cost of your trip. All final payments are due no later than 45 days prior to departure.
Finder’s Bonus: Receive $50 off your trip for each participant you recruit. If you recruit 3 people then you get
$150 off your trip, etc. The participants can be family, friends, co-workers, etc.
Discounts: UWSP Alumni & UWSP Students receive a $50 discount for each trip.
Cancellations and Refunds: Cancellation of trips must be made in writing up to 12 weeks prior to departure
and will be refunded in full less your $200 non-refundable deposit. Requests made within 12 weeks of and
prior to 45 days before departure will be refunded 50% of the tour price (including airfare if applicable).
Cancellations made within 45 days of departure will not be refunded.
Refunds for Missed Days: We are unable to grant refunds for any missed portions of your tour because of
missed or delayed flights. Additionally, no refund is guaranteed for any feature of the tour not used as a
result of weather, personal health or social disturbance.
Insurance: Travel insurance is highly recommended.
Flight Arrangements: Each participant is responsible for purchasing and arranging his or her own flights to
and from Costa Rica (Since many participants use frequent flyer miles and some may travel from different
parts of the U.S. this arrangement is most effective). However, if enough participants travel from the WI area
a group roundtrip flight can be arranged and this group travel would require an additional fee (determined by
size of group) and yet typically costs less than parking at the airport. UWSP Adventure Tours would then
include a van(s) that pick up all group participants and transfers group to airport (airport location based upon
participants’ locale). Please contact the program manager if interested in group flight.
If We Cancel A Trip: Adventure Tours reserves the right to cancel a trip for force majeure or any other
circumstances beyond our control. We also reserve the right to cancel any trip if sign-up is inadequate to
make the trip economically feasible for us to operate or for safety considerations that pose a risk to the
group. If this happens, we will refund your trip in full for land costs. If airfare is booked through Adventure
Tours we will work with our travel agency to the best of our ability to either refund or transfer your flight costs
but there is no guarantee either will happen. Adventure Tours is not responsible for additional expenses
incurred by you in preparing for the trip (e.g. non-refundable air tickets, visa fees, gear, or medical expenses).
I certify that the information I have provided on this form is accurate and correct. I have read and agree to the
above terms and conditions. Enclosed is my $200 deposit to reserve a space for me on this trip. I understand
that Adventure Tours may use any trip photos or video of myself or my child (if signing for a minor) for public
relations and promotional purposes and if I don’t wish photo’s or video of myself or child be used I will notify
Adventure Tours in writing.
___________________________________________
Signature of Participant
_________________
Date
___________________________________________
_________________
Date
Signature of Guardian or Parent (if applicant is under 18 years of age)
Please make check payable to: “UWSP Adventure Tours”
Send to: UWSP Continuing Ed.
2100 Main St., 032 Main Bldg.
Stevens Point, WI 54481