FOR OFFICE USE ONLY inGlialtTED 0 litpo s SAFARI & TRAVEL Co. Ts ASSUMPTION OF RISK & RELEASE OF LIABILITY Date received Date of trip Travel specialist I. acknowledge that I have voluntarily applied to participate on the trip for which I have deposited money (or to a trip which I may subsequently transfer). I am voluntarily participating in this trip with the knowledge of the numerous risks and dangers involved including, but not limited to: negligence on the part of Uncharted Outposts: physical exertion for which I am not prepared: forces of nature: transportation failure where by plane. train. auto. boat. canoe. kayak. horseback or other animals. bicycle. by foot, or by any other conveyances: consumption of alcoholic beverages: risks associated with food or impure water civil unrest: terrorism: criminal activity: dangers associated with wild or other animals: high altitude: accident or illness without access to means of rapid evacuation or availability of medical supplies or services: the adequacy of medical attention once provided: and stolen. lost or misplaced luggage or property. I acknowledge that the enjoyment and excitement of adventure travel is derived in part from the inherent risks incurred by travel and activity beyond the accepted safety of life at home or work and that these inherent risks contribute to such enjoyment and excitement, being a reason for my participation. I HEREBY AGREE TO BE RESPONSIBLE FOR MY OWN WELFARE AND ACCEPT ANY AND ALL RISKS OF DELAY. UNANTICIPATED EVENTS. INCONVENIENCES, ILLNESS, INJURY. EMOTIONAL TRAUMA OR DEATH. I acknowledge that the costs of all Uncharted Outposts trips are based upon trip participants executing the Assumption of Risks, Release of Liability, and Arbitration Agreement. Therefore, as lawful consideration for being permitted to participate on such trip(s). I hereby RELEASE AND DISCHARGE FOREVER UNCHARTED OUTPOSTS FROM AND AGAINST ANY AND ALL LIABILITY ARISING FROM MY PARTICIPATION IN THE