Bisti Planet 50+ Digital Tours

REGISTRATION FORM - Bisti Digital Expeditions

This is a registration form for Bisti Digital Expeditions. Please carefully complete the form. It will help your instructors focus on your needs. Thank you. * Indicates a Required Field

Fee: $499 per Person $150 in Advance $349 due October 6, 2006 Chopawamsic LLC 12200 Montgomery F-205 Albuquerque, NM, 87111 Payment by Check Thank you! Bear Canyon: $13 per Person Van Usage

Name	*
Address	*
City	*
State *	AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX VT VA WA WV WI WY
Zip	*
Home Phone	*
Email	*
Cell Phone
Your WebSite	http://
Expedition/Tour *	Bisti Planet 50+ Digital 2006 Tour - Sep. 15-17 Bisti Planet 50+ Digital 2006 Tour - Oct. 20-22 Bisti Planet 50+ Digital 2006 Tour - Nov. 17-19
Your Objectives	Please tell us about what you would like to derive from Bisti Digital Expeditions. Your desire will help structure the Expedition/Tour.
Where did You learn of Bisti Digital Expeditions?	Blog Book Store Camera Store Magazine Friend Newspaper Radio Senior Center TV Web
Age *	25-30 30-35 35-40 40-45 45-50 50-55 55-60 60-65 65-70

Your Special Photographic Interests

Landscape

Wildlife

Birds

People

Photo Journalism

Flowers

Magic Hour (Sunrise / Sunset)

Your Particular Bisti Interests

Hoodoos

History

Rainforests & Dinosaurs

Sunrise

Sunset

Moonrise

Moonset

Photography

Your Experiences

Have you experienced a Photo Workshop?

Are you acclamated @ 5800' elevation?

Cameras    Lens    Filters   Special Equipment Items Tripod Flashlight Headlamp GPS - Working Knowledge Can You Operate Your GPS Celestial Navigation? Backup / Extra CF Cards / CF Card Reader Extra_Batteries Battery Charger Dust Cleaning Kit Sun Blocker Hiking Boots Moleskin Hat Energy Bars Pack Wet Ones (Hand Wipes) Equipment, Schedules, Regulations, Release, and Risk Waiver      Equipment Every participant is responsible to bring and safeguard his or her own photographic equipment, as well as appropriate clothing, medical supplies, or other special needs. See the list of suggested items in the registration form above.      Expedition Schedules All expedition schedules and plans are tentative as far as subjects, times, and events. We may change schedules or plans, at our discretion, depending on weather, health, or safety considerations, or any other factors considered necessary for health, safety, and advantageous photography. We can't guarantee other environmental conditions may or may not occur.      Special Terms and Regulations Each participant agrees to abide by rules and restrictions placed on land and property, whether owned or governed privately, publicly, or governmentally. Damage or destruction of property or belongings of others by participants, whether willful or accidental, is entirely the responsibility of the inflicting participant. No responsibility or liability for such actions will be placed on Chopawamsic, LLC, Joe Bridwell, or any of our acting agents. Failure to comply with such rules or restrictions may result in removal of responsible participant(s) from the event without compensation or refund of fees paid.      Model Release Each participant agrees any photographs, video tapes, or other images of himself or herself, which may be created during a Chopawamsic, LLC event, can be used by us or our assigns in perpetuity for promotional or advertising purposes with no compensation to any participant.      * * * RELEASE AND ASSUMPTION OF RISK WAIVER * * * All participants of Chopawamsic, LLC Bisti Digital Expeditions events must agree to the terms specified above, and to the following Release and Assumption of Risk Waiver. This agreement is a mandatory requirement to participate or attend any Chopawamsic, LLC event. Persons ("You") registering for a Chopawamsic, LLC event are voluntarily participating in this event, to be led by Joe Bridwell, his staff, agents, guides, or other assigns (hereafter referred to as "we" or "us"). You assume full and complete responsibility of traveling and participating in any Expedition/Tour or related activities. You agree we are not liable and shall not be liable for any accident, personal loss, injury, or property damage incurred to you or your heirs, assigns, or any other beneficiaries in connection with this event. You understand there are certain risks and dangers associated with and directly relating to participation in any such event, including (but not limited to) natural disasters, forces of nature, wild or otherwise uncontrolled animals, other participants or people, various means of travel and transportation (including hiking and walking), terrain or any other areas used for any event, and other related physical conditions or circumstances. You hereby irrevocably waive any and all claims for liability against us (including Chopawamsic, LLC and Joe Bridwell or his other assigns) as a result of your participation in any event. You fully and clearly understand and acknowledge agreeing to this "Release and Assumption of Risk Waiver" is a prerequisite to participating in any and all of our Expeditions, Tours, and events.      YOUR APPLICATION AND PAYMENT FOR A Chopawamsic, LLC EVENT SIGNIFIES YOUR FULL AGREEMENT WITH THESE TERMS AND WAIVER, AND IS BINDING AS IS YOUR SIGNED COPY OF THIS AGREEMENT. Refusal to submit this signed agreement automatically revokes your registration, and no space will be reserved for any event until your signed agreement reaches us by US Mail. Medical Sheet Carried on Person      In case of unexpected circumstance, we suggest you carry on your person a detailed medical history.      Should such circumstances arise, this information might become invaluable to determine further action.      The Bisti is a wilderness ~ there are no trails, there is no water, there are no trees. Travelers Insurance      We suggest you carry travelers insurance for trip cancellation insurance, gear malfunctions, or other unexpected expenses. To review these details, we suggest you look at our Policy Statement, identified below Policy Statement * I have read the above disclaimer and CERTIFY all of information provided on this form is correct to the best of my knowledge. Please make check out to: Chopawamsic LLC Please send check to: Chopawamsic LLC 12200 Montgomery NE F-205 Albuquerque, NM, 87111.