Registration, Liability Release Form

Participant Information

First name you want on name badge

Last name

Multi-line address

Country/Region

Address

City

Zip / Postal code

Home Phone

Cell Phone

Email Address

Request to sit forward/first 6 rows on bus:

Note: If YES, Doctor's note is required at least 30 days prior to departure.

Yes

List emergency contact NOT traveling on this trip.

Emergency Contact Name and Relationship

Emergency Contact Phone

Pick Up Location

If multiple locations are offered : Write one: Newnan or Carrollton

Trip Information

Trip/Event Name and Destination: Mackinac Island

Departure Date: SEP 27 / Return Date: OCT 3

Group Name: Senior Friends of Newnan

Registration and Payment Terms

Registration amount is $915.00 per person double occupancy.

The registration amount is $1154 for a single room.

A deposit of $75 per person is due upon signing up for the trip.

The final payment due date for this trip is JUL 20, 2026.

Your full payment must be received no later than this date.

Late payments will result in additional fees or cancellation of participation.

Late Fee/Late Reservation/Late Room Changes Policy

I understand that if payment is not received by the stated due date, a late fee will be charged.

I understand if I reserve a trip or change room status resulting in additional money having to be sent ro a tour company or vendor within 30 days prior to the departure date, a late fee will be charged.

Late fee amount: $15.00

I agree to pay any applicable late fees associated with overdue balances.

I agree to pay any applicable late fees for registration and/or room changes within 30 days prior to departure.

Assumption of Risk

I understand participation in this trip/event may involve risks, including but not limited to travel hazards, illness, accidents, injuries, property loss, damages, disability or death.

Liability Release

I fully release, absolve, waive, hold harmless, and agree not to sue Senior Friends of Newnan and/or Loving Life Travelers and their officers, agents, representatives, group leaders, vendors, and contractors from any and all claims resulting in any loss, theft, damage, injury, death, storage of items, expense, cost, or harm (whether foreseen or unforeseen) which I may have or which may occur on account of participation in the trip/event.

Senior Friends of Newnan and/or Loving Life Travelers may contract with independent contractors or vendors to provide transportation, guide services and/or all other travel related services. Senior Friends of Newnan and/or Loving Life Travelers assume no responsibility or liability, however caused, for injury, loss of limb or life, loss or damage to person or property in connection with any service provided by an independent contractor or vendor including but not limited to transportation services.

Waiver of Injury Claims

I agree to waive and relinquish any and all claims I may have arising out of, connected with, or in any way associated with the trip/event. This waiver includes claims for personal injury, illness, property damage, financial loss, disability, or death.

Indemnity Agreement

I agree to indemnify, hold harmless and defend Senior Friends of Newnan and/or Loving Life Travelers and their officers, agents, sponsors, group leaders, affiliates, representatives, vendors, and contractors from any and all claims from injuries, including death, damages, costs, and losses sustained by me and arising out of, connected with, or in any way associated with the trip/event.

Health Acknowledgement

I certify that I am able to care for myself independently or travel with a personal assistant. This includes safely navigating walkers/wheelchairs and functioning independently while on trips. Trip/event group leaders have the right to remove anyone at anytime during the trip if they feel the trip member is mentally or physically incapable of continuing and/or if a trip member's continued participation jeopardizes the group's or his/her own health and/or safety. I understand any costs resulting from removal are at my expense and no refunds will be given.

Punctuality/Keep It Clean

The Golden Rule is: "Early is on time. On time is late. Late doesn't get on the bus." Be on time means you must arrive at the bus at least 5 to 10 minutes before the bus is scheduled to depart. If you are late, the bus may leave without you. I understand that if I am left behind, I will be responsible for catching up with the group. Any costs resulting from being left behind are at my expense, and no refunds will be given.

Keep your space clean. If something gets spilled, notify your group leader and bus driver so it can be cleaned up.

Emergency Medical Authorization

In the event of an emergency, I authorize the organizers, group leaders, and designated representatives to secure emergency medical treatment on my behalf including contacting emergency services (911) and arranging for transportation to a medical facility if necessary. I understand reasonable efforts will be made to contact my emergency contacts before treatment when possible. I understand that organizers and group leaders assume no liability regarding provision of medical care.

I accept financial responsibility for all medical care rendered to me and any associated transportation costs.

Acknowledgement of Understanding

I acknowledge that I have carefully read and fully understand this document. I understand that by submitting this form below, I am giving up certain legal rights including my right to sue. I acknowledge that I am submitting the agreement freely and voluntarily and intend by submitting the form to be a complete and unconditional release of all liability. I agree to abide by all rules, policies, and instructions provided by the organizers and group leaders.