Wufoo

Workshop Application and Waiver Copy

Please complete this workshop application. Fields with a '*' are required.

Please choose a workshop
(pay special attention to dates and lodging options) *
May 6-9, 2010: Four Day Desert Landscape Workshop with Lodging in Moab Utah: $1399 May 6-9, 2010: Four Day Desert Landscape Workshop with Lodging (single) in Moab Utah: $1699 May 6-9, 2010: Four Day Desert Landscape Workshop Only in Moab, Utah: $899 July 3, 2010: On Day Wildflowers and Waterfalls Workshop in Breckenridge, Colorado: $99 September 24, 2010: Business of Wedding Photography Workshop $199 September 25, 2010: One Day Fall Colors Workshop $99 October 1-3, 2010 Three Day Fall Landscape Workshop in Grand Tetons National Park, with hotel $1199 October 1-3, 2010: Three Day Fall Landscape Workshop in Grand Tetons National Park, with hotel (single) $1399 October 1-3, 2010: Three Day Fall Landscape Workshop in Grand Tetons National Park, workshop only $899 December 26, 2010: One Day Winter Landscape Workshop $149 January 15, 2011: One Day Winter Landscape Workshop $149 March 5, 2011: One Day Winter Landscape Workshop $149
Name * First Last
Email *
Phone Number * - -
Please use a mobile number that you can be reached at during the workshop.
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Please enter your mailing address
Emergency Contact name *
Emergency Contact phone number * - -
Applicant's Goals and Experience
& Medical Conditions
Tell us a little about your photography goals and experience. What would you like to learn? What would like you to accomplish after this workshop. Also, if you are applying for a workshop with field session, use this space to tell us about any medical conditions or allergies your instructor should be aware of in case of emergencies.

Please describe your photography experience and what you would like to accomplish during this workshop. Also please list any physical limitations you may have so that we can taylor this workshop experience to our student's needs
Please indicate what format you will be using *
Digital SLR 35mm Film (E-6 Processing not available in all areas) Compact Digital Other

Liability Waiver & Covenant not to Sue

I/we have carefully read the description of the workshop/activity listed above. I/we hereby
waive, release and discharge any and all claims against Timothy Faust, Altitude Gallery LTD,
its employees, instructors and/or volunteers for personal injury, death or property loss I/we
may have or which may accrue as a result of participation in said activities. This release is
intended to discharge in advance Timothy Faust, Altitude Gallery LTD, its employees,
instructors and/or volunteers from any and all liability arising out of my/our participation in
said activities, even though that liability may arise out of the carelessness, negligence on the
part of the persons or entities mentioned above. It is understood that theses activities involve
an element of danger and risk, and knowing those risks I/we assume those risks. It is further
agreed that this waiver, release and assumption of risks is binding on my/our heirs and assigns.
I/we agree to indemnify and to hold the above persons or entities free and harmless from any
loss, liability, damage, cost or expense which they might incur as the result of my death or
injury or property damage that I/we might sustain while participating in said activity.

I understand that along with the beauty in wild places, there is also inherent danger in visiting
and photographing them. I further understand that workshops may be held in dangerous
outdoor locations which may include but are not limited to such hazards as steep cliffs or high
heights, difficult hiking, scrambling or climbing on dangerous and sometimes difficult terrain,
rock fall, ice, snow, swift moving water, flash floods, and dangerous weather conditions such
as extreme heat and cold, snow, rain, and/or lightening. I agree that I will be in good physical
health and have proper clothing and footwear for changing and dangerous weather conditions.

I/WE HAVE CAREFULLY READ THIS AGREEMENT, WAIVER AND RELEASE AND
FULLY UNDERSTAND ITS CONTENTS. I/WE UNDERSTAND THAT THIS IS A
RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF/OURSELVES
AND TIMOTHY FAUST AND ALTITUDE GALLERY LTD AND I SIGN IT OF MY
FREE WILL.

Electronic Signature:
Enter your name in this field if you understand and accept the terms of this agreement *
Do Not Fill This Out