Please Complete a form for each traveler
Destination:
Country:
Start Date of Program:
Participant (as it appears on passport):
Last Name:
First Name:
Middle Name:
Mailing Address:
City: State:
Zip Code:
E-mail Address:
Re-type E-mail:
Day Phone : **
Fax: **
Evening Phone: **
** only numbers
Passport Information:
Date of birth:
Nationality:
Passport No.:
Expiration Date:
Acomodations:
Double Single
Share Name of roommate:
Share please assign a roommate
(Single supplement fee will apply when match if not possible)
Smoker Non smoker
 
Please Complete a form for each traveler

ASSUMPTION OF RISK, LIABILITY RELEASE AUTHORIZATION

This Assumption of Risk, Liability Release Authorization Agreement ("Agreement") is entered into between Participant and Mondo Verde Expeditions LLC (MVE).

ACKNOWLEDGEMENT AND LIMITATIONS.  Participant acknowledges and agrees that (1) MVE has the unqualified right to accept or decline, or to retain, any person as a tour member whether before departure or en route; (2) any expenses incurred by delays or events beyond the control of MVE is the sole responsibility of Participant; (3) the Participant's airline tickets, when issued, shall constitute the sales contract between the airline companies and the Participant; (4) children are the sole responsibility of parents and/or guardians of the children at all times during The Tour; (5) risks on The Tour include but are not limited to, the hazards of traveling in remote and/or mountainous terrain, accident or illness in remote places without readily available medical facilities, the forces of nature, the hazards of war, civil insurrection, terrorism and street crime, (6) airports, roads, railroads, highways, bridges, buildings and other man-made structures, as well as motor vehicles, aircraft and other conveyances associated with The Tour may not be constructed or maintained up to standards customary in the United States, (7) it is the sole responsibility of the Participant to be familiar with and capable of handling the physical and/or mental demands associated with The Tour, and (8)  Participant has read, understands and agrees to all provisions contained in this Agreement.

ASSUMPTION OF RISK AND RELEASE OF LIABILITY.  Participant acknowledges and understands that participation in The Tour may involve risk of bodily injury or harm (including death) to Participant, or may involve risk of harm to the property of Participant.  Participant acknowledges that s/he fully understands and appreciates the risk inherent in The Tour, and Participant expressly and without limitation agrees that any and all risks and/or damage or destruction to property is fully and completely assumed by Participant.  With a full understanding of the risks involved in The Tour, Participant hereby expressly and completely releases MVE, their officers, directors, employees, agents or representatives from and against all liability, claims, lawsuits, damages or losses of any kind, known and unknown, which may be connected with, resulting from, or arising out of the planning, arranging or implementation of or participation in The Tour by Participant, regardless of whether such liability claims, lawsuits, damages or losses are caused by the active or passive negligence of MVE.  This release by Participant shall include all claims, lawsuits, damages or losses of any nature whatsoever, including but not limited to, all claims for bodily injury, personal injury, economic loss and property damage.

INDEMNITY.   Participant and, if applicable, the parents and guardians of Participant hereby agree to defend (including the payment of attorneys fees and costs), indemnify and hold harmless MVE, their officers, directors, employees, agents and representatives from and against any and all losses suffered by MVE, their officers, directors, employees, agents and representatives as a result of any claims, lawsuits or actions arising out of or in any way relating to participation in The Tour by Participant. 

RESPONSIBILITY/DISCLAIMERS STATEMENTS
Mondo Verde Expeditions LLC (MVE) acts only as an agent for the various independent suppliers that provide hotel accommodations, transportation, sightseeing, activities, or other services connected with this tour.  Such services are subject to the terms and conditions of those suppliers. MVE and its respective employees, agents, representatives, and assigns accept no liability whatsoever for any injury, damage, loss, accident, delay, or any other incident which may be caused by the negligence, defect, default of any company or person in performing these services.  Responsibility is not accepted for losses, injury, damages or expenses of any kind due to sickness, weather, strikes, hostilities, wars, terrorist acts, acts of nature, local laws or other such causes.  

All services and accommodations are subject to the laws and regulations of the country in which they are provided.  MVE is not responsible for any baggage or personal effects of any individual participating in the tours/trips arranged by MVE.

Individual travelers are responsible for purchasing a travel insurance policy, if desired, that will cover some of the expenses associated with the loss of luggage or personal effects.

BINDING EFFECT OF AGREEMENT.  This Agreement shall be binding upon all heirs, successors, representatives and assigns of Participant.

GOVERNING LAW.  This Agreement shall be interpreted and construed in accordance with the laws of the State of Colorado, without reference to its conflict of laws principles.
 
I accept the above terms and conditions
 
    By:
  [Participant Name]
 
If participant is under ageof 18, name of parent or guardian:
Name:
 
 
Completed and signed form must br sent to guaranty services
 
Travel Insurance
Mondo Verde Expeditions (MVE) LLC, HIGHLY recommends that our clients protect themselves with travel insurance to prevent any financial losses.
 
Please Complete a form for each traveler
MONDO VERDE EXPEDITIONS LLC
EMERGENCY CONTACT, HEALTH INFORMATION & MEDICAL PROXY
 
Travelers Name:
Emergency Contact Name:
Relationship:
Day Phone: ** Night Phone: **
Name of Physician:
Phone Number: **
**only numbers
Please specify any health or dietary problems:
Current Medication:
Please specify any dietary needs and food allergies:
 
MEDICAL PROXY: In case of an emergency Mondo Verde Expeditions LLC (MVE) will spare no effort to contact the emergency contact person listed on the Emergency Information Form and/or the physician also listed on the Emergency Contact Information Form to request permission to secure emergency treatment and hospitalization of Tour Participant. If we are not able to reach a family member, guardian or doctor listed on the Emergency Information Form, the Tour Participant gives permission to MVE to hospitalization and secure emergency treatment.
 
BINDING EFFECT OF AGREEMENT: This Agreement shall be binding upon all heirs, successors, representatives and assigns of Participant.
 
GOVERNING LAW: This Agreement shall be interpreted and construed in accordance with the laws of the State of Colorado, without reference to its conflict of laws principles.
 
    By:
  [Participant Name]
 
Completed and signed form must be sent to guaranty services
 
Travel Insurance
Mondo Verde Expeditions (MVE) LLC, HIGHLY recommends that our clients protect themselves with travel/medical evacuation insurance to prevent any financial losses.
 
 
I accept all terms and conditions of the
assumption of risk liability and the medical proxy


Client Information Form
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