Bird Language 2017 Registration

Welcome to the registration for Bird Language Course on Salt Spring Island, BC.

To complete registration, please fill in the form below, click SUBMIT, and then complete payment by sending an etransfer to info@wisdomoftheearth.ca for CDN $68.25 ($65 plus $3.25 GST). Include a note about what the payment is for.
(You may also send an E-transfer to info@wisdomoftheearth.ca. Please include GST.)

Once we receive your registration, we will send you more details about what to bring and directions to where we'll meet. We look forward to welcoming you at our workshop!

* = Required

First Name*

Last Name*

Email*

Home Phone Number*

Cell Phone Number*

Additional Emergency contact name and phone 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, canoeing, sea kayaking, 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 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 and/or the participation of my child in this activity is purely voluntary, and I elect to participate or allow my child 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 or my child's participation in this activity or 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/or my 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 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.

I understand and have read the above*

Does you have asthma and/or serious allergies? If so, do you have medication or carry an epi-pen with you? (please explain) *

Do you child have any medical conditions or physical disabilities that may limit participation in this program? If so, please describe condition, disability, limitation, and history: *

Any serious allergies to any insects, plants, foods, medications, etc- List below. Please describe your reaction (if you know them) to any of the above. *

Additional notes to Wisdom of the Earth staff

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