Name *

First Name

Last Name

Phone

Country

(###)

###

####

Mailing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Special dietary requirements

Vegetarian

Vegan

Dairy-free

Gluten-free

Nut Allergy

Release of Liability *

Acknowledgement Waiver and Release from Liability By entering my name and clicking the box below, I hereby acknowledge that Rogue Equipment LLC (aka Rogue Expeditions), its employees, managers, officers, directors and agents (collectively “Rogue”) sponsors, promotes or otherwise engages in activities or events which are inherently dangerous and could cause minor, severe and/or permanent injuries or death. Examples of risks associated with such activities or events include but are not limited to: (a) exertion and extreme weather/climate-related injuries or illness such as heart attacks, heat exhaustion, altitude sickness, and frostbite; (b) injuries and or death resulting from maritime incidents such as drowning; (c) injury or death resulting from exercising or travelling in dangerous locals (examples include foreign countries which are not as safe as the United States and on uneven or demanding terrain with no safety apparatus); (d) typical risks associated with travel such as insect bites and resulting illnesses or diseases, food or drink related illnesses, plane crashes, traffic accidents, or other modes of transportation such as camels, and (e) those resulting from theft of or damage to personal property. I acknowledge and agree that: (1) I have consulted with a physician and I am physically capable of completing strenuous aerobic and anaerobic exercise for sustained periods and that Rogue has not, and will not, evaluate my physical ability; (2) I will determine whether any instructions given by Rogue during the activities or events are safe for me to complete and do not rely on alleged representations, express or implied, given by Rogue as to the safety of any such activity; and (3) I hereby assume any and all risks associated with such activities or events. I, FOR MYSELF, MY PAST, PRESENT AND FUTURE AGENTS, ATTORNEYS, REPRESENTATIVES, PREDECESSORS, SUCCESSORS, ASSIGNS, HEIRS AND EXECUTORS, DO HEREBY WAIVE, RELEASE AND DISCHARGE ROGUE, ITS PAST, PRESENT AND FUTURE OFFICERS, DIRECTORS, AGENTS, ATTORNEYS, AND ANY MEMBERS OTHER THAN MYSELF, PARENTS, SUBSIDIARIES, PREDECESSORS, SUCCESSORS, AFFILIATES, ASSIGNS AND SPONSORS, AND REPRESENTATIVES (THE "ROGUE PARTIES") FROM ANY AND ALL MATTER OF LIABILITY, CLAIMS FOR DAMAGES, CAUSES OF ACTION, SUITS, PROCEEDINGS, COMPENSATION, ATTORNEYS' FEES, COSTS AND EXPENSES OF SUITS, CLAIMS AND DEMANDS WHATSOEVER, WHICH MAY ARISE FROM MY PARTICIPATION IN ANY ACTIVITY OR EVENT WITH IS IN ANY WAY AFFILIATED WITH ROGUE, INCLUDING, BUT NOT LIMITED TO ANY AND ALL CLAIMS. LOSSES OR LIABILITIES FOR DEATH, PERSONAL INJURY, PARTIAL OR PERMANENT DISABILITY, PROPERTY DAMAGE, MEDICAL OR HOSPITAL BILLS, THEFT OR DAMAGE OF ANY KIND, INCLUDING ECONOMIC LOSSES, WHICH MAY ARISE OUT OF OR RELATE TO MY PARTICIPATION IN OR TRAVELING TO AND FROM A ROGUE EVENT OR ACTIVITY.. I HEREBY ASSUME ANY AND ALL OTHER RISKS ASSOCIATED WITH PARTICIPATING IN ROGUE EVENTS OR ACTIVITIES, INCLUDING CONTACT OR EFFECTS OF OTHER PARTICIPANTS AND EFFECTS OF WEATHER INCLUDING COLD, HEAT AND HUMIDITY. I AGREE NOT TO SUE ANY OF THE ROGUE PARTIES FOR ANY AND ALL CLAIMS MADE OR LIABILITIES ASSESSED AGAINST THEM AS DISCHARGED HEREIN. I FURTHER INDEMNIFY AND HOLD HARMLESS THE ROGUE PARTIES FROM ANY AND ALL CLAIMS MADE OR LIABILITIES ASSESSED AGAINST THEM AS A RESULT OF (I) MY ACTIONS OR INACTIONS (II) THE ACTIONS, INACTIONS OR NEGLIGENCE OF OTHERS INCLUDING THOSE PARTIES HEREBY INDEMNIFIED (III) THE CONDITIONS OF THE FACILITIES, EQUIPMENT OR AREAS WHERE THE EVENT OR ACTIVITY IS BEING CONDUCTED AND (IV) AND OTHER HARM CAUSED BY AN OCCURRENCE RELATED TO A ROGUE EVENT OR ACTIVITY. I GRANT PERMISSION FOR THE USE OF MY NAME AND/OR LIKENESS RELATING TO MY PARTICIPATION IN A ROGUE EVENT AND I WAIVE ALL RIGHT TO ANY FUTURE COMPENSATION TO WHICH I MAY OTHERWISE BE ENTITLED AS A RESULT OF THE USE OF MY NAME OR LIKENESS. I HEREBY AFFIRM THAT I AM EIGHTEEN (18) YEARS OF AGE OR OLDER, I HAVE READ THIS DOCUMENT, I HAVE HAD THE OPPORTUNITY TO CONSULT WITH MY PERSONAL LEGAL COUNSEL SHOULD I SO DESIRE, THAT I WAS NOT FORCED OR COERCED INTO SIGNING THIS DOCUMENT, AND THAT I UNDERSTAND, ACKNOWLEDGE AND AGREE WITH CONTENTS HEREIN.

I acknowledge that I have read, understand and accept this waiver.

Cancellation Policy *

Within 30 days of signup: Full Refund (if you pay by credit card we retain a 2.9% processing fee each way) 121+ days from the trip start date (but after the 30 day grace period): Deposits are non-refundable 61-120 days from the trip start date: 50% of total payment refunded** 60 days or less from the trip start date: No refunds **This only applies to participants who have paid their balances on time. If you do not pay the balance by the due date and cancel after the fact, we will retain your full deposit.

I acknowledge that I have read, understand and accept the cancellation policy.