Participant Release Form

 Please carefully read the following agreement.  In consideration for being permitted to participate in Excellence in Fiction Writing Seminar and Retreat in the Andes of Ecuador (the “Retreat”) to be held in part at local Quito hotels and for the most part at Hacienda Cusin, (the “Host”), Calle Chiriboga s/n Otavalo 100457 EC, San Pablo del Lago, Ecuador in conjunction with Leonardo Wild and Write by the Water Writing Retreats (the “Organizer”), on April 3-13, 2019, where (“you” or the “Participant”) agree to accept and be bound by these terms and conditions:

MODIFICATION / CANCELLATION

1. The Organizer reserves the right to make changes to any and all aspects of the Retreat (which may include without limitation, changes to the types and/or timing of activities available during the Retreat, items and/or services included with the Retreat, the itinerary, and/or the nature of the Retreat classes) if, in the Organizer’s sole discretion, the Organizer deems it necessary to do so due availability of third party vendors (“Vendors”), weather conditions, conditions that may be hazardous, dangerous, or otherwise  adverse or threatening, other circumstances out of the Organizer’s control, or for any other reason considered commercially necessary by the Organizer.  The Participant will not be eligible for any refunds of any amounts based on any such changes to the Retreat.

2. The Organizer reserves the right to cancel the Retreat at any time prior to the start date, reason in the Organizer’s sole discretion and, in such an event, you will receive a full refund of the amount you remitted to the Organizer, but in no event will the Organizer be responsible for any other amount, including preparation costs, airfare, travel documents, or any other Losses.

3. All cancellations by the Participant must be in writing and emailed to the Organizer at the contact email address specified on the Website.

INSURANCE

4. The Organizer strongly recommends the purchase of appropriate travel insurance for the Retreat. You are solely responsible for the cost of any travel insurance and ensuring that you are adequately insured for the full duration of the Retreat with respect to possible illness, injury, death, property damage, loss of baggage and personal items, cancellation and/or curtailment, and/or any other potential losses, damages, costs, expenses, or liabilities (collectively “Losses”). You will be solely responsible for any Losses related to your failure to procure travel insurance.  The Organizer is not responsible for any Losses you incur and/or sustain.

PHOTOS, VIDEO, OTHER MEDIA

5. You irrevocably grant the Organizer all rights to use, reproduce, display, exhibit, publish, distribute, and/or produce derivative works based on your image, likeness, and voice as recorded by any camera and/or on any video, audio, and/or other media (collectively, “Likeness”) worldwide, in perpetuity, without compensation, payment, or other additional consideration of any kind, for any lawful purpose, including without limitation for marketing and trade purposes. You agree that your Likeness may be used, reproduced, displayed, exhibited, published, edited, or distributed by the Organizer at its sole discretion.  You understand that your Likeness may be used in various publications, promotional or marketing materials, and/or social media, unrestricted by time or geographic area and consent to such uses.

6. You hereby waive the right to inspect or approve any and all materials in which your Likeness may appear. You further waive any right to royalties or other compensation arising or related to the use of your Likeness. This release applies to all photographic, audio, and/or video recordings collected as part of, in connection with, and/or during the Retreat (by the Organizer or any third party).

VOLUNTARY PARTICIPATION IN STRENUOUS ACTIVITY

7. You acknowledge that you are voluntarily participating in the Retreat which may include strenuous physical activity including without limitation walking, running, hiking, dancing, paddleboarding, swimming, yoga, pilates, energy exercises, body movement, and various other exercises or physical activity as part of Retreat classes or activities (“Physical Activity”). You acknowledge that you are fully aware of the risks and hazards connected with participation in the Retreat and/or engaging in Physical Activity, which may include the risk of serious injury (e.g., heart attacks, muscle strains, pulls, tears, broken bones, shin splints, and other illnesses) or death, and you hereby elect to voluntarily participate in such Physical Activities as part of the Retreat.

HEALTH AND FITNESS ELIGIBILITY

8. You represent that you are over the age of 18 years old or, have the full consent to attend the Retreat by a legal parent or guardian over the age of 18 years old.

9. You represent that you are healthy, in good physical and mental health, and are fully capable of participating in, the Retreat. You further represent that you do not suffer from any medical conditions or disabilities that may restrict, limit, prevent, or preclude your participation in the Retreat, including any Physical Activities.

10. You have discussed and addressed any questions or concerns you may have about your physical or mental health with the appropriate health care professional prior to the Retreat start date and documentation from your physician confirming your clearance to participate in the Retreat can be provided upon request.

11. If, at any time, you have any doubts about your physical condition or fitness to participate in any aspect of the Retreat, you will cease participation in the same and seek appropriate medical attention.

12. The Organizer reserves the right in their sole discretion to refuse your participation in the Retreat, any Retreat classes, Physical Activities, and/or any other activities, due to medical, fitness, or if at any time you demonstrate behavior that may result in injury to yourself or others.

13. You understand and agree that if you are pregnant, you will take necessary steps to ensure your doctor and health care providers know you are participating in the Retreat.  You assert that you are of good health to participate in the Retreat and will alert to the fact of your pregnancy the Organizer and any Vendors whose sessions you participate.

ASSUMPTION OF RISK.

14. You understand that serious accidents may occur during Physical Activities, and that Participants can sustain fatal and/or serious personal injury.  You agree to solely and exclusively assume full and complete responsibility for and the risks inherent in travel and engaging in Physical Activity which may include injury, death, property damage, and/or any other kind of Liability which may occur during the Retreat.

INJURY

15. In the event you are injured while participating in the Retreat, you agree to assume all financial obligations for any and all medical costs you incur.  You acknowledge and agree that in no event shall the Organizer be liable or responsible for any losses or liabilities arising out of your participation in the retreat.

MEDICAL CARE

16. In the event that you should require medical care or treatment, you agree to be financially responsible for any costs incurred as a result of such treatment. You are aware and understand that you should carry your own health insurance.

17. Although you acknowledge that there is no obligation of any person to provide any Participant with medical care during, prior to, or after a Retreat, in the event that necessary medical treatment is provided to me, I hereby consent to such care. This release shall apply to all medical care.

18. The Organizer is not a medical practitioner and the Retreat is not a provider of medical services.

PERSONAL PROPERTY

19. I acknowledge and agree that I am responsible for my equipment and all personal property during the Retreat and that the Organizer or any Vendors or third parties are not responsible in any way for my property whether it is lost, stolen or damaged.

RETREAT PROPERTY

20. In the event that any damage to equipment or facilities, of either the Host or any Vendor, occurs as a result of your willful actions, neglect or recklessness, you acknowledge and agree to be held liable for any and all costs associated with any actions of neglect or recklessness.

RULES AND RESPECT

21. The Participant agrees to abide by all rules and regulations presented by the Host, Organizer, and any Vendors and treat all, and fellow participants with a high level of courtesy and respect for the mutual benefit of all participants.

WAIVER OF LIABILITY, INDEMNITY AND RELEASE

22. In consideration for participating in the Retreat, you, and you on behalf of your executors, administrators, heirs, successors, assigns voluntarily assume full responsibility for and hereby release, waive, discharge, hold harmless, and covenant not to sue the Organizer, its officers, members, agents, contractors, employees, volunteers, guides, and other representatives (each a “Company Party” and collectively, the “Company Parties”) for any and all claims, demands, actions, causes of action, and/or losses (including but not limited to any exemplary, direct, indirect, incidental, special, consequential, punitive, or other damages, medical expenses, lost wages/income, loss of services, lost profits, property damage, pain, illness, and death) (collectively “Liabilities”) whatsoever arising out of or in any way related to your travel to and/or participation in the Retreat and/or any activities conducted in connection therewith, regardless of whether such liabilities are caused by the negligence of any Company Party or otherwise, and regardless of whether such liability arises in tort, contract, strict liability, or otherwise, even if any Company Party has been advised of the possibility of such.

23. You acknowledge that whether or not you elect to purchase or not purchase travel insurance, you will not look to any of the Company Parties for reimbursement for any Liabilities suffered or occurring during your travel and/or participation in the Retreat.

24. You, and on behalf of your executors, administrators, heirs, successors, and assigns agree to indemnify and hold harmless the Company Parties from any and all Liabilities (including without limitation court costs and attorneys’ fees) that one or more of the Company Parties may incur as a result of your participation in the retreat, whether caused by the negligence of any company party or otherwise (but excluding any gross negligence or willful misconduct of a company party), to the fullest extent allowed by applicable law.

ENTIRE AGREEMENT

25. This Agreement constitutes the entire agreement between you and the Organizer, and supersedes any prior agreement, regarding the subject matter herein.  You acknowledge and represent that no oral representations, statements, or inducements, apart from those set forth herein, have been made to you by any Company Party.

FORCE MAJEURE

26. If the Organizer is prevented (directly or indirectly) from performing any of its obligations under this agreement by reason of any Act of God, strike, trade dispute, fire, inclement weather, breakdown, interruption of transportation networks/means, government or political action, acts of war or terrorism, acts or omissions of a third party, or for any other cause whatsoever outside of Company’s reasonable control, the Organizer will be under no liability whatsoever to you and may, at company’s sole discretion, by written notice to you, either cancel the Retreat or take any other reasonable action.

CHOICE OF LAW AND JURISDICTION

27. You irrevocably agree that this Agreement shall be governed by the laws of the State of Georgia, that any mediation, suit, or other proceeding must be filed or entered solely and exclusively in Georgia, and any courts of appeal therefrom shall have sole and exclusive jurisdiction to settle any dispute arising under or in connection with this Agreement (including any disputes as to this Agreement’s existence or validity).  You waive any objection (on the grounds of lack of jurisdiction, forum non conveniens, or otherwise) to the exercise of jurisdiction by such courts.

INTERPRETATION

28. You acknowledge and agree that this Agreement, including the releases and waivers of liability herein, are intended to be as broad and inclusive as permitted by applicable law.

SEVERABILITY

29. If any portion(s) of this Agreement is/are held by a court of competent jurisdiction to be unlawful, invalid, or unenforceable, such portion(s) shall be interpreted and/or reformed without further action of the parties hereto to render them valid and enforceable when applied to the facts at issue and the lawfulness, validity, and enforceability of such provision(s) as applied to any other facts, and the lawfulness, validity, or enforceability of the remaining provisions of this Agreement shall in no way be affected or impaired thereby.

WAIVER

30. The failure or delay by the Organizer to enforce or exercise any provisions of this Agreement shall not constitute or be deemed a waiver of such provision or any other provisions herein.   Furthermore, any waiver or breach of any provision of this Agreement shall not amount to a waiver of any other provision.

HEADINGS

31. The headings in this Agreement are for convenience only and in no way define, limit, or describe the scope or intent of any provisions herein.

YOU ARE AWARE OF THE POTENTIAL DANGERS INCIDENTAL TO PARTICIPATING IN THE RETREAT, AND ACKNOWLEDGE THAT THIS IS A CONSENT, RELEASE OF LIABILITY AND A WAIVER OF YOUR LEGAL RIGHT TO COLLECT DAMAGES IN THE EVENT OF INJURY, OR ANY OTHER LIABILITY.  BY YOUR SIGNATURE BELOW, IT IS YOUR INTENTION TO EXPRESSLY ASSUME ALL RISK OF PERSONAL INJURY, DEATH, PROPERTY DAMAGE, AND ANY OTHER LIABILITY UPON YOURSELF, TO THE EXCLUSION OF THE ORGANIZER AND ALL COMPANY PARTIES, AND TO EXEMPT THE ORGANIZER AND ALL COMPANY PARTIES FROM ALL LIABILITY.

Participant Name (print):

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Participant Signature: ………………………………………

Date:  ……………………………………….…………………………………………………..

If the Participant is under the age of 18 years old, this release must be signed by a parent or guardian:

Participant Name (print):

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I hereby certify that I am the parent or guardian of _______________________________________, named above, and hereby give my consent without reservation to the foregoing on behalf of this individual.

Name of Parent/Guardian (print):

…………………………………………………..…………………

Relationship to Participant (print):

…………………………………………………..…………………

Parent/Guardian Signature:

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Date:  ………………………………..……