Print LEGAL NAME as it appears on Passport: Exact FIRST Exact MIDDLE Exact LAST

Transcription

1 FWSA INT L ITALY TRIP REGISTRATION FORM Ski Week - Cortina d Ampezzo, Italy Mar. 5-12, * and Optional extension - Florence & Rome, Italy Mar , ** * Tentative Departure dates for the BASIC Cortina Ski Week: depart the US on March 4, and return from Italy on March 13, Tent. Departure dates for the BASIC Cortina Ski Week & EXTENSION Florence & Rome: depart the US Mar. 3, & return from Italy Mar. 19, ** (If using your OWN air transportation, you must arrive by 5pm in Cortina on Mar. 5, ) Please print clearly: The information you provide is for the exclusive use of FWSA and will not be sold for solicitation. Print LEGAL NAME as it appears on Passport: Exact FIRST Exact MIDDLE Exact LAST ** It is MANDATORY to SEND a BLACK/WHITE COPY OF YOUR VALID PASSPORT Valid thru Sept. 19, ** Mailing Address: Nickname: City: State: Zip Code: PHONE: Home: ( ) Cell ( ) Work: ( ) Date of Birth: Day Mo Year Passport Number Expiration Print Address: Male Female Skier/Snowboarder Non-Skier / Non-Boarder I am a MEMBER of Ski Club OR a FWSA DIRECT MEMBER FWSA Council (circle): Arizona, Bay Area, Central, Intermountain, Los Angeles, Orange, Northwest, San Diego, Sierra EMERGENCY INFORMATION Emergency Contact Immediate Family member NOT ON THIS TRIP (required for all participants): Name: Relationship: Contact Number: Cell Number: List Food Allergies and/or drug allergies (optional): Medical Conditions (optional): List Over-the-Counter/prescription drugs taken regularly (optional): List any Special Dietary Needs: I have been advised that the FWSA trip package does not include travel insurance and I understand that I do have the option to purchase my own Travel Insurance. FWSA DOES HIGHLY RECOMMEND TRAVEL INSURANCE. (Travel Ins. details offered by our tour operator will be provided or you may purchase from your own provider) I am aware that I am financially responsible for myself whether or not I purchase Travel Insurance. I am aware it is my responsibility to obtain all legal documents required for travel including passports & visas. I am aware that my passport must be valid at least 6 months after return of trip (Sept. 19, ) I have been advised of the CANCELLATION Policy - the deposit is completely refundable until Nov. 15, See complete CANCELLATION Policy and associated fees listed on the documents. NO REFUNDS after Jan. 15, unless a compatible replacement is found. There may also be a transfer fee and associated vendor/supplier fees. NO REFUNDS for any NO-SHOWS. I have received and read a copy of the FWSA Conduct Policy and agree to comply. I am aware that I must be a current member of a FWSA Club or a FWSA Direct member. I further certify that I m a current FWSA Club or a FWSA Direct member and that the information I have provided on this form is accurate. I am aware that the culture of the place(s) I am visiting might not be what I am normally accustomed to in the USA. I am aware that FWSA may use images taken during this trip for marketing and promotional purposes, I authorize and hold harmless FWSA and its agents for the use of my image and I may sign an exemption form to exclude the use of my pictures being used for this purpose. 1 Participant Signature OR Parent/Legal Guardian for Minor Date CST #

2 TRANSPORTATION OPTIONS MARK AN X Our goal is to travel effortlessly, seamlessly and use the best flight options when available. Please read all the options carefully before deciding on your transportation choice. The following estimated rates are based on FWSA Group Air from SFO and LAX (min. of 10 seats per itinerary) The SFO & LAX group air prices DO INCLUDE Fuel Surcharges, Departure Taxes and current exchange rate of $1.10 US vs 1 Euro. Air pricing subject to change till tickets are actually issued. The tent. Air schedules require an overnight stay upon arrival or departure. Choose 1 transp. option below. BASIC CORTINA Ski Week - Air Transportation & 1 overnight in Mestre: Option #1: FWSA Air Transportation San Francisco, CA $500 Deposit Approx. Air & 1 night Hotel cost - $1, pp. + $85. (Dbl occ) = $ or Approx. Air & 1 night Hotel cost - $1, pp. + $115. (Single Supp.) = $ Option #2: FWSA Air Transportation Los Angeles, CA $500 Deposit Approx. Air & 1 night Hotel cost - $1, pp. + $85. (Dbl occ) = $ or Approx. Air & 1 night Hotel cost - $1, pp. + $115. (Single Supp.) = $ BASIC CORTINA & FLORENCE/ROME Extension Air Transp. & 1 overnight in Mestre: Option #3: FWSA Air Transportation San Francisco, CA $500 Deposit Approx. Air & 1 night Hotel cost - $1, pp. + $85. (Dbl occ) = $ or Approx. Air & 1 night Hotel cost - $1, pp. + $115. (Single Supp.) = $ Option #4: FWSA Air Transportation Los Angeles, CA $500 Deposit Approx. Air & 1 night Hotel cost - $1, pp. + $85. (Dbl occ) = $ or Approx. Air & 1 night Hotel cost - $1, pp. + $115. (Single Supp.) = $ Secondary airports will be available and arranged on an individual basis and airline Deviations for RETURN flights are limited and will need to be requested EARLY! Contact Debbie Stewart for details! The Following Air Deviations are purchased for YOU as a NON-REFUNDABLE ticket and must be paid for at the time of booking: Option #5: FWSA Air Transp. Fresno, CA Contact Debbie Stewart $ is Due in Full Option #6: FWSA Air Transp. Phoenix, AZ Contact Debbie Stewart $ is Due in Full Option #7: FWSA Air Transp. Portland, OR Contact Debbie Stewart $ is Due in Full Option #8: FWSA Air Transp. San Diego, CA Contact Debbie Stewart $ is Due in Full Option #9: FWSA Air Transp. Other Contact Debbie Stewart $ is Due in Full Option #10: OWN AIR Transportation Be sure to check the appropriate box identifying your details. Do review the FWSA tentative Group Air schedules so you arrange YOUR OWN AIR flights to coordinate with the FWSA group air and bus transfer schedule otherwise you must make your own transportation arrangements to the hotel and/or airport! OWN Air Transportation for CORTINA BASIC Ski Week ONLY, the following is required: Venice Arrival on Mar. 5 th : you must arrive at the Venice Marco Polo Airport (VCE) by or before 2:45pm. Cortina Departure on Mar 12 th : the FWSA departure bus will be going to the Mestre Venice airport hotel, NOT the airport. Mar. 12 th you will stay 1 night at the Venice Airport Hotel in Mestre & take the bus to the airport on Mar. 13 th. The Mestre hotel cost is $85.00 Dbl Occ. Or $ Single Supplement. Mar. 12 th, you will take the FWSA departure bus from Cortina to the Mestre hotel, but NO overnight hotel stay. I will make all my own air and ground transportation arrangements to and from Cortina. OWN Air Transportation for CORTINA and FLORENCE & ROME EXTENSION, the following is required: Venice Arrival on Mar. 4 th : you must arrive at the Venice Marco Polo Airport (VCE) by or before 4:55pm or meet at the Venice airport hotel in Mestre by 9:15am on Mar. 5 th to take the FWSA bus to Cortina. ROME Departure on Mar. 19 th : your Rome departure flight should NOT be earlier than 6:10am Mar. 4 th I will meet the group at the airport & stay 1 night - Venice Airport Hotel in Mestre & take the bus to Cortina Mar. 5 th. The Mestre hotel cost is $85.00 Dbl Occ. Or $ Single Supplement. Mar. 4 th, I will take the FWSA departure bus from the Mestre hotel, but NO overnight hotel stay. (Meet at hotel by 9:15am) I will make all my own air and ground transportation arrangements to Cortina and from Rome. *Your OWN Air & Ground Transportation details are to be provided to Debbie Stewart along with any flight changes! AND If your flight is cancelled, delayed or you miss your OWN AIR flight, it is Your Responsibility and Cost in arranging your own ground transfer to your hotel. [Please inform Debbie Stewart if such situations occur call or text ] 2

3 TRIP & LODGING OPTIONS MARK AN X 1st, Choose your TRIP OPTION - Please select one of the following: Option I: Cortina ONLY Ski Week Trip (See page 6 for FWSA Tent. Air Transp., & Canc. Schedules) Option II: Cortina Ski Week and Florence & Rome Extension Trip Option III: Florence & Rome Only STAND ALONE Trip We are offering 2 Lodging properties during the Int l Ski Week in Cortina d Ampezzo The Hotel Concordia Parc, a 4 star hotel combines the romantic glamour of the past with the all modern innovations. It is conveniently located, just a short distance to the ski bus stop and in the pedestrian zone for shopping & après-ski strolling. Corso Italia, 28, Cortina d'ampezzo BL, Italy The Hotel Ancora, built in 1826, it is the oldest hotel in Cortina and it has been owned by the same family for 4 generations. It is located right in the centre and has the atmosphere of a private house created by the owners, with refined rooms, typical wooden furniture and a lot of antiques. This 4 star charming boutique hotel offers the classic old world beauty and modern amenities. It too is situated in the prime pedestrian zone which has access to shops, ski lifts and night life. Corso Italia, 62, Cortina d'ampezzo BL, Italy 2nd, Choose your Cortina Lodging Pkg. Option MARK AN X [not including AIR] (Pricing is based on a min. of 80 people) Option A: HOTEL CONCORDIA**** - Standard Room Double Occ. $ pp Option B: HOTEL CONCORDIA**** - SINGLE Supp. Rm. $ pp Option C: HOTEL CONCORDIA**** - Standard Rm - Triple Occ. $ pp Option D: HOTEL ANCORA**** - Standard Room Double Occ. $ pp Option E: HOTEL ANCORA**** - SINGLE Supp. Room. $ pp Option F: HOTEL ANCORA**** - Jr. SUITE Room Dbl. Occ. $ pp Option G: HOTEL ANCORA**** - SUITE - Double Occ. $ pp 3 rd, Optional Post-Trip to Florence & Rome (including bus) - MARK AN X 3 nights in Florence 4* Hotel Adriatico and 4 nights in Rome 4*Superior Hotel Mediterraneo (Pricing is based on a min. of 30 people) Option K: Florence & Rome Hotels**** - Double Room Dbl. Occ. $ pp Option L: Florence & Rome Hotels**** - Single Supplement Room $ pp 4th, (NO Cortina) Florence & Rome ONLY Stand Alone Trip -MARK AN X below 3 nights in Florence 4* Hotel Adriatico and 4 nights in Rome 4*Superior Hotel Mediterraneo This Stand Alone Florence & Rome trip pricing DOES NOT include any FWSA Air transportation or airport shuttle. If you need assistance with air & ground transportation for the Florence & Rome Trip, please contact Debbie Stewart. Option M: Florence & Rome Hotels**** - Double Room Dbl. Occ. $ pp Option N: Florence & Rome Hotels**** - Single Supplement Room $ pp 3

4 LODGING/ROOMMATE I HAVE A ROOMMATE I DO NOT HAVE A ROOMMATE: [for office use only] YOUR NAME: ROOMMATE: I Need Female Roommate I Need a Male Roommate Are you a Smoker? Yes No Do you Snore excessively? Yes No Describe your personality [Ex. Outgoing, quiet, early riser, adventuresome, reserved, skier, nonskier ] Assigned roommate: PAYMENT METHOD Information X ** PLEASE mail your completed registration forms & waiver, along with a check for your trip deposit. Subsequent payments may be made online by credit card or by mailing a personal check, cashier check, or money order. Your registration will not be complete, and your spot will not be reserved, until you have submitted your documents (including black/white copy of valid passport) and have paid your initial deposit. **if you choose to pay by credit card, a link to the online payment system will be provided on your accounting statement, for subsequent payments once we have received your registration. Please mark one of the following for making future payments: I will continue to make payments by check, cashier check or money order. I will continue to make payments by PayPal and/or Credit Card via online payment method. Do send me the information in order to pay online. Send ALL the Registration Forms, Trip & Transportation Options, Waiver, Lodging & Method Form and a legible BLACK & WHITE photocopy of your Valid passport (good through Sept. 19, ), and Check to: Debbie Stewart, VP of Int l Travel FWSA 430 S. Church St. Visalia, CA Cell: 559/ FwsaIntlTrvl@prodigy.net Make check payable to FWSA. Please note FWSA Int l ITALY Trip on each check. There will be a charge of $25.00 for return checks from your bank. Deposit Amount: $ Check # Other: 4

5 FWSA Tentative Group Air Transp. & Lodging Packages and Cancellation Schedules Option I: Cortina d Ampezzo Basic Ski Week ONLY Basic Ski Trip - CORTINA ONLY Air France San Francisco Air Tentative = $1132. DEPART ARRIVE March 4, AF83 SFO/CDG 250pm 1035 (+1) March 5, AF1726 CDG/VCE 105pm 245pm March 12, 1 overnight stay at the Venice airport in Mestre AF1327 VCE/CDG 645am 835am March 13, AF84 CDG/SFO 1030am 155pm Basic Ski Trip - CORTINA ONLY Air France/ KLM Los Angeles Air Tentative = $1094. March 4, AF65 LAX/CDG 345pm 1135am (+1) March 5, AF1726 CDG/VCE 105pm 245pm March 12, 1 overnight stay at the Venice airport in Mestre KL1650 VCE/AMS 630am 840am March 13, KL601 AMS/LAX 950am 1150am Option I: s Cortina d Ampezzo ONLY Ski Week - Schedule & Cancellation Policy DUE DATE SFO & LAX Transp. Land Pkg. Total DUE Initial Deposit Due Now! $ $ $ nd July 10, 2015 $ $ $ $300.00* 3 rd Sept. 1, 2015 $ $ $ $300.00* Single Supp., Jr. Suites & $0 Suite Rooms = 4 th Nov. 1, 2015 $ $ $600.00* FINAL PAYMENT *A $ late fee may be applied if payments not made by due dates. Dec. 10, 2015 BALANCE of Air Transp. BALANCE of Land Pkg. Balance Due *Cancel. Cancel. Date Fees No Penalty up to Nov. 15, 2014 Full Penalty NO Refund* 2015 Dec. 15, Dec. 15, 2015 Between Dec. 16, 2015 Jan. 15, After Jan. 15, *Cancellation Policy - Penalty fee and any additional vendor or supplier charges may be added. (Substitutions may be made with associated change fees applied details will be on a case by case basis) 5

6 FWSA Group Air Transp. & Lodging Packages and Cancellation Schedules Option II: Cortina Ski Week and Florence & Rome Extension Trip CORTINA and FLORENCE & ROME KLM San Francisco Air Tentative = $1094. DEPART ARRIVE March 3, KL606 SFO/AMS 245pm 1030am(+1) March 4th - OVERNIGHT at airport hotel in Mestre, take FWSA bus to Cortina on Mar 5 th KL1655 AMS/VCE 310PM 455PM March 19, KL1596 ROM/AMS 610AM 850am March 19, KL605 AMS/SFO 1015am 145pm CORTINA and FLORENCE & ROME KLM Los Angeles Air Tentative = $1094. March 3, KL602 LAX/AMS 150pm 905am (+1) March 4th - OVERNIGHT at airport hotel in Mestre, take FWSA bus to Cortina on Mar 5 th KL1655 AMS/VCE 310pm 455pm March 19, KL1596 ROM/AMS 610am 850am March 19, KL601 AMS/LAX 950am 1250pm s Option II: Cortina Ski Week and Florence & Rome Extension Schedule & Cancellation Policy DUE DATE SFO & LAX Transp. Land Pkg. Total DUE Initial Deposit Due Now! $ $ $ nd July 10, 2015 $ $ $ $300.00* 3 rd Sept. 1, 2015 $ $ $ $300.00* Single Supp., Jr. Suites & $0 Suite Rooms = 4 th Nov. 1, 2015 $ $ $600.00* FINAL PAYMENT *A $ late fee may be applied if payments not made by due dates. Dec. 10, 2015 BALANCE of Air Transp. BALANCE of Land Pkg. Balance Due *Cancel. Cancel. Date Fees No Penalty up to Nov. 15, 2014 Full Penalty NO Refund* 2015 Dec. 15, Dec. 15, 2015 Between Dec. 16, 2015 Jan. 15, After Jan. 15, 6

7 FWSA Lodging Package and Cancellation Schedules Option III: STAND ALONE Florence & Rome Extension ONLY For those who choose to join us for the Florence & Rome trip only, we will be happy to arrange your air transportation on a case by case basis. Contact Debbie Stewart for arrangements. s Initial Deposit DUE DATE Due Now! Transportation arranged as individual ticket Land Pkg. DUE in FULL upon booking $ nd July 10, $ FINAL PAYMENT *A $ late fee may be applied if payment not BALANCE made by due date. Nov. 1, of Land Pkg. Total DUE $ air price *Cancel. Fees $ $300.00* Balance Due $600.00* Cancel. Date No Land Penalty up to Nov. 15, 2014 Full Penalty NO Refund* *Cancellation Policy - Penalty fee and any additional vendor or supplier charges may be added. (Substitutions may be made with associated change fees applied details will be on a case by case basis) 2015 Dec. 15, 2015 Between Dec. 16, 2015 Jan. 15, After Jan. 15, 7

8 FWSA TRIP CONDUCT POLICY This policy applies to all persons participating on a Far West Ski Association ski week or trip. It is intended to maximize the enjoyment for all trip participants and provide guidelines for the FWSA Travel Staff, Council Trip Leaders, and assigned Trip Assistants. All trip participants are requested to observe common courtesy and generally accepted standards of social and moral behavior. In accordance with Federal and State laws, the Far West Ski Association will enforce a "Zero Tolerance Policy" on illegal drug use at any FWSA sponsored event or trip. Failure to observe this policy will automatically remove you from participation in future FWSA events. Participants shall adhere to the requirements of FWSA trip packages (e.g., lift tickets) and participants agree not to transfer, resell, or barter all or portions of that package. Only FWSA, or the issuing agency may compensate the participant for the unused portion or permit transfer. Failure to comply may result in exclusion from future FWSA events. Alcohol and tobacco use is allowed in moderation and where permitted by law. FWSA Travel Staff, Council Trip Leaders, or assigned Trip Assistants, will ask a participant to cease any loud, obnoxious, or offensive behavior. Participants who refuse to cooperate will be reported to local security or local police. Far West Ski Association maintains a strict policy prohibiting sexual harassment and harassment because of race, religion, color, national origin, ancestry, disability, medical condition, marital status, sexual orientation, age, or any other basis made unlawful by any applicable law or ordinance or regulation. Prohibited harassment in any form, including verbal, physical and visual conduct, threats, demands, and retaliation is unlawful and will not be tolerated. If, after a request to refrain from this behavior, the participant continues, FWSA Travel Staff, Council Trip Leaders, and assigned Trip Assistants may contact local security or local police. Profanity and off-color humor is only permitted if it is not offensive to other participants. Please stop the offensive behavior if asked by another participant, FWSA Travel Staff, Council Trip Leader, or assigned Trip Assistant. Parents/Legal Guardians of minor children under the age of 18 are responsible for the supervision and behavior of their children. Children under12 years will be under the direct supervision of their parents/legal guardians at all FWSA events. Parents/Legal Guardians are responsible for providing supervision of their children under 12 years of age during the time that they are attending a FWSA function without their children (e.g., children under 12 will not be left alone in the lodging rooms). FWSA Travel Staff, Trip Leaders, assigned Trip Assistants, and/or FWSA Board of Directors will attempt to resolve problems in a mutually beneficial manner. When resolution cannot be achieved, FWSA Travel Staff, Trip Leaders, and assigned Trip Assistants have the authority to call on-site security or local police to resolve the problem. Participants may be excluded from a trip at their own expense and without reimbursement of trip expenses. 8

9 FWSA INTERNATIONAL SKI WEEK Ski Week: Cortina d Ampezzo, Italy Mar. 5-12, (Dep. Mar. 3 or 4th); Extension Trip: Florence & Rome, Italy Mar , SPORT PARTICIPANT RELEASE OF LIABILITY, WAIVER OF CLAIMS, EXPRESS ASSUMPTION OF RISK AND INDEMNITY AGREEMENT. Please read and be certain you understand the implications of signing. Express Assumption of Risk Associated with Sport, Venue Use and Related Activities. I, do hereby affirm and acknowledge that I have been fully informed of the inherent hazards and risks associated with all activities of FWSA International Ski Week including but not limited to alpine skiing, snowboarding, tubing, and tobogganing, certain additional risks, dangers and hazards including, but not limited to boarding, riding, and disembarking ski lifts, transportation of equipment related to the activities, and traveling to and from activity sites in which I am about to engage. Inherent hazards and risks include but are not limited to: 1. Risk of injury from the activity and equipment utilized is significant including the potential for broken bones, severe injuries to the head, neck, and back or other bodily injuries that my result in permanent disability and death. 2. Possible equipment failure and/or malfunction or misuse of my own or others equipment. 3. I AGREE THAT I WILL WEAR APPROVED PROTECTIVE GEAR AS DECREED BY THE GOVERNING BODY OF THE SPORT I AM PARTICIPATING IN. However, protective gear cannot guarantee the participant s safety. I further agree that no helmet can protect the wearer against all potential head injuries or prevent injury to the wearer s face, neck or spinal cord. 4. Variation and/or steepness of terrain, variation or changes in surfaces including but not limited to snow surfaces, ice, bare spots, rocks, stumps, debris, cliffs, trees, fences, posts, trees, light poles, signs, buildings, roads, walkways, ramps, rails, stairs, pyramids, manual pads, bowls, half-pipes, jumps, padded and non-padded barriers, other persons, and other natural and man-made hazards. 5. My own negligence and/or the negligence of others, including but not limited to operator error and guide decision making including misjudging terrain, weather, riding surfaces or other obstacles. 6. Exposure to the elements and temperature extremes may result if frost nip, frost bite, heat exhaustion, heat stroke, sunburn, hypothermia and dehydration. 7. Dangers associated with exposure to natural elements include but are not limited to avalanche, rock fall, inclement weather, thunder and lighting, severe and or varied wind, temperature and other weather conditions. 8. Accidents or illness occurring in remote places where there are no available medical facilities. 9. Fatigue, exhaustion, chill, and/or dizziness, which may diminish my/our reaction time and increase the risk of accident. 10. Impact or collision with other athletes, spectators, facility employees, pedestrians, motor vehicles, and cyclists. *I understand the description of these risks is not complete and unknown or unanticipated risks may result in injury, illness, or death. Release of Liability, Waiver of Claims and Indemnity Agreement In consideration for being permitted to participate in the above described activity (ies) and related activities, I hereby agree, acknowledge and appreciate that: 1. I HEREBY RELEASE AND HOLD HARMLESS WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER CAUSED BY NEGLIGENCE OR OTHERWISE, the following named persons or entities, herein referred to as releasees: Far West Ski Association (FWSA) and their directors and officers, FWSA Ski Councils and their directors and officers, FWSA Ski Clubs and their directors and officers, and their successors and assigns. 2. To release the releasees, their officers, directors, employees, representatives, agents, and volunteers from liability and responsibility whatsoever and for any claims or causes of action that I, my estate, heirs, survivors, executors, or assigns may have for personal injury, property damage, or wrongful death arising from the above activities whether caused by active or passive negligence of the releasees or otherwise. By executing this document, I agree to hold the releasees harmless and indemnify them in conjunction with any injury, disability, death, or loss or damage to person or property that may occur as a result of my engaging in the above activities. 3. By entering into this Agreement, I am not relying on any oral or written representation or statements made by the releasees, other than what is set forth in this Agreement. 4. This agreement shall apply to any and all injury, disability, death, or loss or damage to person or property occurring at any time after the execution of this agreement. This release shall be binding to the fullest extent permitted by law. If any provision of this release is found to be unenforceable, the remaining terms shall be enforceable. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, I FULLY UNDERSTAND ITS TERMS, I UNDERSTAND THAT I HAVE GIVEN UP LEGAL RIGHTS BY SIGNING IT, AND I SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. S/ Signature of Adult Participant Name of Adult Participant (Please Print) Date FOR PARTICIPANTS OF MINORITY AGE: This is to certify that I, as Parent, Guardian, Temporary Guardian with legal responsibility for this participant, do consent and agree not only to his/her release of all Releasees, but also to release and indemnify the Releasees from any and all liabilities incident to his/her involvement in these programs for myself, my heirs, assigns, and next of kin. S/ Signature of Parent or Adult Legal Guardian if Participant is a Minor Name of Parent or Adult Legal Guardian (Print Clearly) Date 9