Registration Form

BePeace in Costa Rica

July 30 – August 10, 2010

Please complete and sign this form; complete and sign Waiver & Release Form;

and submit your deposit of $300 (payable to Unity Rising) by March 23 to:

Althea Harris or Kristin Powell, Unity Rising, 1600 W Broadway, Columbia MO 65203

PAYMENT CENTER (only click here if you have already registered)

Trip Registration--Costa Rica
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YOUR ADDRESS
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EMERGENCY CONTACT INFORMATION
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FOOD PREFERENCE
LODGING PREFERENCE
  3. Please assign a roommate (If a roommate is not available, I understand a $100 single supplement will apply).
PAYMENT INFORMATION:
  1. Please make checks payable to Unity Rising and send with these forms to above address
FLIGHT OPTIONS
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  4. Contact:Althea Harris or Kristin Powell, Unity Rising, 1600 W Broadway, Columbia MO 65203
Waiver and Release
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TO: Unity Rising and Association of Unity Churches
  1. I, the Releasor, being of lawful age, in consideration of being permitted to participate in any Unity Rising journey led by the Releasee, WAIVE, RELEASE, and DISCHARGE the Releasee, its owners, officers, directors, employees, members, and successors, and all business associates and partners involved in the presentation of this journey and each of them their board members, officers and employees, from the time I leave home until I return from any trip or event sponsored by Releasee, from all liability for or by reason of any damage, loss or injury to person and property, even injury resulting in the death of the Releasor (or the children under the Releasor’s supervision), which has been or may be sustained in consequence of the Releasor's (or children under the Releasor’s supervision) participation in the activity described above, and notwithstanding that such damage, loss or injury may have been caused solely or partly by the negligence of the Releasee. I hereby acknowledge and agree that I have carefully read this Waiver and Release agreement, that I fully understand same, and that I am freely and voluntarily executing same. By signing this release I will be forever prevented from suing or otherwise claiming against the Releasee for any property loss or personal injury that I may sustain while participating in or preparing for any Unity Rising event or journey. I have the opportunity to seek independent legal advice prior to signing this Waiver and Release agreement. I understand that I would not be permitted to participate in the above noted activity unless I signed this Waiver and Release agreement. I understand that this Waiver and Release agreement is binding on me, my spouse, my heirs, my executors, administrators, personal representatives and assigns. I acknowledge that I do not have any physical limitations, medical ailments, physical or mental disabilities that would limit or prevent me from participating in the above mentioned activity, and, if required, will obtain a medical examination and clearance. This release contains the entire agreement between the parties to this release and the terms of this release are contractual and not a mere recital. This Waiver and Release Agreement will be construed in accordance with and governed by the laws of the State of Missouri, and it is acknowledged by the Releasor to be as broad and inclusive as permitted by the laws of this jurisdiction. I HAVE READ AND UNDERSTAND THIS AGREEMENT, AND I AM AWARE THAT BY SIGNING THIS AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS AND ASSIGNS MAY HAVE AGAINST THE RELEASEE(S).
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  3. Cancellations made prior to 120 days of tour will be refunded monies paid to date less $300 deposit. Cancellations made 120-30 days prior to departure will not be refunded unless a substitute traveler is booked, then a refund of all monies less the $300 deposit can be made. Cancellations less than 30 days before departure, will forfeit the full price of the tour.
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