NAME, ADDRESS AND PHONE NUMBER: ______________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
NUMBER IN PARTY: _____________ DO YOU REQUIRE MEALS: _________________
DATES OF STAY : ____________________________________________________________
DO YOU REQUIRE GUIDING SERVICES: ________________________________________
DEPOSIT: # of cabins X # of days X $80 CAD X 25% = _____________________________
meals; # of guests X # of
days X $60 CAD X 25% = _______________________
SCUTTLEBUTT LODGE
BOX 503, CARMACKS, YUKON, Y0B 1C1, CANADA
EMAIL: scuttlebuttlodge@hotmail.com
TRIP REGISTRATION
NAME OF TRIP: ____________________________ DATES: ________________________
NAMES, ADDRESSES AND PHONE NUMBERS OF PARTY MEMBERS: ____________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
AGES OF PARTY MEMBERS: _________________________________________________
MEDICAL PROBLEMS OR DISABILITIES IN GROUP: ____________________________
___________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
ANY DIETARY RESTRICTIONS WE SHOULD KNOW ABOUT: ___________________
____________________________________________________________________________
____________________________________________________________________________
”
HEIGHT, WEIGHT AND SHOE SIZE OF PARTY MEMBERS (for clothing and life
jackets): ____________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
WILL YOU EXTEND YOUR STAY AT THE LODGE BEFORE OR AFTER THE TRIP?
PLEASE GIVE DETAILS (number of people, dates): ______________________________
____________________________________________________________________________
____________________________________________________________________________
CAN WE HELP YOU CONTINUE YOUR HOLIDAY (reservations, transportation
or bookings): _________________________________________________________________
____________________________________________________________________________
DEPOSIT: $500 CAD X ___ (# of persons) _ _ _ _ _ _ _ TOTAL
DEPOSIT: $___________
AGREEMENT OF TERMS OF PARTICIPATION
TRIP NAME: _______________________________ TRIP DATES:_____________________
PLEASE READ CAREFULLY:
Due to the current legal atmosphere in Canada as well as insurance considerations, we must insist that each participant be familiar with and agree to the following document prior to departure. If you have any questions regarding any part of this document, please contact us prior to signing. This form must be completed and submitted with your final payment. No one may take part in a Scuttlebutt Lodge vacation without submitting this document.
Insurance coverage is the responsibility of each individual participant. Cancellation and travel coverage is available through travel agents.
Please note that this document must be signed and received by us in the mail at our office before you may depart with the group.
DEFINITIONS:
WINTER WILDERNESS DOG SLED AND SKI TRIPS: include dog mushing; riding in the sled; skiing; snowshoeing; ice fishing; use of dogs, knives, axes, saws, woodstoves, campfires; hiking; nature observations; crossing lake, creek and river ice; lifting; transportation by vehicle in winter conditions; handling dogs and other associated activities.
In consideration of Scuttlebutt Lodge accepting my application I agree to this:
RELEASE OF CLAIMS AND WAIVER OF LIABILITY.
I understand that winter wilderness dog sled , ski tripping and canoeing
involves certain dangers, not all of which can be listed here. Among
the more obvious and frequent are:
1. violent and unpredictable winter weather including severe cold
2. hazards related to winter travel on forest trails, lake and river
ice
3. unfamiliar country, where the participant may become lost, get off
route or be
separated from the rest of the group
4. hazards related to working with dogs no matter how well trained
I am not relying on any oral or written statements made by Scuttlebutt
Lodge or its agents, whether in brochures, advertisements, videotapes,
in individual conversations or otherwise to lead me to become involved
in this program on any basis other than my assumption of the risks involved.
SCUTTLEBUTT LODGE
AGREEMENT OF TERMS AND PARTICIPATION
I accept all of the risks and the possibility of death, personal injury,
property damage
and loss resulting from my involvement with the trip I am taking with
Scuttlebutt Lodge.
I release Scuttlebutt Lodge, its partners, employees, contractors, guides, agents and representatives from any and all liability for any personal injury, death, property damage or loss I may suffer as a result of my participation in their trip, howsoever and wheresoever caused on the part of Scuttlebutt Lodge, its partners, employees, contractors, guides, agents or representatives.
I confirm that I have read over this agreement before signing, that I understand it, and that it will be binding not only on me , but also on my heirs, my next of kin, my executors, administrators and assigns.
I agree that the laws of the Yukon Territory govern this contract and that any legal concerns will be handled in the competent and fair courts in Whitehorse, Yukon, Canada.
MEDICAL INFORMATION:
Notwithstanding my assumption of risk, the following medical conditions and /or histories should be known by the guide(s):
PLEASE LIST ANY MEDICAL CONDITIONS THAT REQUIRE SPECIAL A ATTENTION: ____________
_____________________________________________________________________________________________
ALLERGIES: ________________________________________________________________________________
HAVE YOU HAD A MAJOR OPERATION IN THE PAST 3 YEARS? ______________________________
_____________________________________________________________________________________________
I hereby also agree to permit other members of the trip to take film
and photographic records of my participation in this tour.
Name: ___________________________ Date: ____________________
Signature: ____________________________ Witnessed: ________________________
Please send signed form for each member of party by mail to:
Scuttlebutt Lodge
Box 503
Carmacks, Yukon, Canada
YOB 1C1
