BC Art of Mentoring 2017 Registration

FILL IN the form below, CLICK SUBMIT, and then COMPLETE PAYMENT at the bottom, using the shopping cart.
Payment is via Paypal (Paypal account, bank account or credit card). Please use this system if at all possible, to streamline our registration process.
Email ingrid@wisdomoftheearth.ca for alternate payment plans.

NOTE:  All sections of the registration form must be filled in to submit successfully. Please write NONE or N/A if the section does not apply to you.

All prices are in Canadian dollars. 5% GST will be added at check-out.

BC Art of Mentoring 2017 Registration

Welcome to the registration for the Art of Mentoring on Salt Spring Island, BC. To complete
registration, please answer these questions and make payment at the bottom. We will send more details as the date approaches and look forward to
seeing you at the event!

* = Required

First Name*

Last Name*

Address*

Email*

Age*

Phone Number*

Please check whether you would like to participate in the Ring 1 or Ring 2 Program *
*If it’s your first year you will automatically be in Ring 1. If you are returning you have the option of participating in either Ring 1 or Ring 2. Please contact ingrid@wisdomoftheearth.ca if you have questions about what the best fit is for you.
Ring 1Ring 2

Full NAME, AGE and EMAIL of additional ADULT family member you are registering (spouse, partner, etc). Please indicate whether they want to join Ring 1 or Ring 2. *
Please write NONE if you coming alone, or if people in your party are registering separately.

Names and ages of Children, Youth or Teens you are registering*
Please write NONE if you aren't registering any children at this event.

Emergency contact name and phone number *

Family Physician name and phone number *

Insurance provider name and policy number *

PARTICIPANT AGREEMENT, RELEASE AND ASSUMPTION OF RISK *

In consideration of the services of Wisdom of the Earth Wilderness School, their agents, owners, officers, volunteers, participants, employees, and all other persons or entities acting in any capacity on their behalf, I hereby agree to release, indemnify, and discharge Wisdom of the Earth Wilderness School, on behalf of myself, my children, my parents, my heirs, assigns, personal representative and estate as follows:

1. I acknowledge that my participation in outdoor adventure based activities climbing, hiking, camping, backpacking, sea kayaking, sailing and fishing entails known and unanticipated risks that could result in physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity. Furthermore, Wisdom of the Earth employees have difficult jobs to perform. They are trained and seek safety, but they are not infallible. They might be unaware of a participant's fitness or abilities. They might misjudge the weather, the elements, or the terrain. They may give inadequate warnings or instructions, and the equipment being used might malfunction.

2. I expressly agree and promise to accept and assume all of the risks existing in this activity. My participation in this activity is purely voluntary, and I elect to participate in spite of the risks.

3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Wisdom of the Earth Wilderness School from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity or my use of Wisdom of the Earth's equipment or facilities or facilities which they use or rent, including any such claims which allege negligent acts or omissions of Wisdom of the Earth or any persons acting on their behalf.

4. Should Wisdom of the Earth or anyone acting on their behalf, be required to incur attorney's fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs.

5. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I am willing to assume the risk of any medical or physical condition I may have.

6. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect. By signing this document, I acknowledge that if anyone is hurt or property is damaged during my participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against Wisdom of the Earth on the basis of any claim from which I have released them herein.

I have read and agree to these terms and conditions*

MEDIA RELEASE *

I hereby grant free permission for Wisdom of the Earth Wilderness School to use images of myself and child participating in their programs or events for outreach purposes, including but not limited to photo, audio, and / or video media. Please consider granting this release to us if at all possible, as our ability to successfully share our programs with new participants depends on having representative media. 

YesNo

Medical Questions *

If you, your partner or your children have any personal medical conditions or problems that Wisdom of the Earth should be aware of, it is your responsibility to acquaint us with the existing condition both in this form as well as at the registration for the program. All information gathered will be held in confidence and used only to render proper assistance to you should the need arise. You should know that it is possible for participants with a variety of medical/ psychological difficulties to successfully complete our courses, but we MUST be aware of these conditions for all of our benefit. Failure to disclose such information could result in serious harm to you and your fellow students.

I understand and have read the above*

Do you or anyone in your party have asthma and/or serious allergies? If so, so you have medication or carry an epi-pen? (please include NAME of participant and explain) *

Do you or anyone in your party have a heart condition?__________If so, please describe your limitation, medications (if any) and history (include NAME of participant if registering more than one): *

Do you or anyone in your party have any physical disabilities that may limit participation in this program? If so, please describe disability, limitation, and history (include NAME of participant): *

Allergies/Intolerance to any insects, plants, foods, medications, etc for everyone in your party. - List below. Please describe reactions (if you know them) to any of the above. Please include NAME of participant(s). *

List any prescription medications that you or anyone in your party take, the condition prescribed for, the doses and schedules for any such medications, and any known drug reactions. Do you experience any side effects? Please include NAME of participant(s). *

Any mental, emotional or psychological issues we should be aware of at this time for anyone in your party ? Please include NAME of participant(s). All information is kept confidential (may be shared with relevant staff) and is meant to provide a supportive and safe atmosphere for all involved in the program. *

Pertinent medical history *

Dietary Info *

Meals will be mostly organic, with as much local farm fresh produce as possible, as well as wild salmon and carefully sourced chicken and meat. Please WRITE THE FIRST NAME of each participant behind their preferred dietary choice (or "NONE").

Omnivore (eats everything):

Vegetarian (no fish/chicken/meat):

Gluten-free:

Dairy-free:

Serious allergies (explain):

Additional notes to Wisdom of the Earth staff

ONLINE PAYMENT:

Costs include all registration, tuition and program fees, facility use, camping, tea and snack bar, and 3 delicious, organic, farm-fresh meals per day.

The Art of Mentoring is a community-building offering, not a money-making venture. We work hard to make the price as low as we can, given the costs of running this big event. Hundreds of volunteer hours make this possible. Still, there are families who would very much like to attend, who are not able to afford the cost.

If you are financially able, we invite you to consider paying full cost for each adult (rather than the earlybird or spouse discount), and/or to consider adding one or more $100 Scholarship donations to your registration order. 100% of these funds will go to supporting lower income families to attend. Thanks for considering this!

Clean, rustic cabins with beds (includes sheet and pillow, bring your own blanket or sleeping bag) are available at additional cost.

All prices are in Canadian dollars. 5% GST will be added at check-out.

Cancellation Policy:
Wisdom of the Earth Wilderness School has implemented this cancellation policy based on the time, resources, deposits (based on numbers), and staffing that goes into planning and facilitating the Art of Mentoring program. Cancellations and transfers to other programs cost us time and money, and can prevent others from attending.
If you cancel for any reason:
• Cancellations and transfers made 21 or more days before the first day of the Art of Mentoring will receive a full refund, less $100 administrative fee (per family).
• Cancellations and transfers made 8-20 days before the first day of the Art of Mentoring will receive a refund of 50% of the total program tuition.
• Cancellations and transfers made 7 or less days before the first day of the Art of Mentoring will receive no refund or credit. This includes if you do not show up.

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