Application: Ironwood Tree Experience 2020 Your Name:* First Last Your Date of Birth:* Date Format: MM slash DD slash YYYY Your Email:* Your cell phone number or the best number to reach you:*Your Address:* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Why are you interested in the WorldWildWeb program?*If you are under 18 years old, you must provide parent/guardian informationParent/Guardian Name: First Last Parent/Guardian Email: Parent/Guardian Phone Number:Do you share the same address as this Parent/Guardian? Yes, we have the same address No, my Parent/Guardian has a different address Parent/Guardian Address:If you are under 18 and your parent/guardian has a different address than you, please enter it here. Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Would you like to share the information of another Parent/Guardian? Yes No Parent/Guardian 2 Name: First Last Parent/Guardian 2 Email: Parent/Guardian 2 Phone Number:Parent/Guardian 2 Address:If Parent/Guardian 2 address is different from Parent/Guardian 1 address. Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code If you are new to ITE please complete this section.What is the name of the school that you are attending?How did you hear about Ironwood Tree Experience?Acknowledgement and Release* I have read and agree to terms The Acknowledgment and Assumption of Risks and Release and Indemnity Agreement represents a part of Ironwood Tree Experience's (ITE) risk management practices. Please read the entire document carefully. The “Acknowledgement and Assumption of Risks” section explains some of the activities in which you might choose to be engaged by your choice of courses, as well as some of the associated risks, hazards, and dangers you may face. Many ITE courses engage in field activities/trips, exercise-related activities, and some travel to remote wilderness settings and/or engage in training in such skills as rock climbing, various kinds of boating, skiing, yoga, etc. This section contains your acknowledgment, acceptance, and assumption of the risks of those activities, whether or not they are specifically described. We cannot predict every possible scenario; we have simply listed numerous examples. We seek to inform you of the kinds of activities, risks, and possible outcomes you might be facing. If you have questions or concerns, we expect you to contact us. Why do we not promise a safe program? Because a “safe program” would mean not exposing ourselves to any risk. We often expose ourselves to risk by traveling to backcountry settings, exploring nature and even cooking on stoves. These types of activities have inherent risks and are part of some of our programs. Inherent risks are those that are integral to the very nature of the activity. Without the inherent risk, the activity would lose its essential nature. For example the risk of injury from lightning increases as one climbs higher, and it is an inherent risk to being in mountainous environments. While we can make judgments about the risks and consequences, there is no way to guarantee safety. We strive to make good judgments. However, judgment is not infallible. Misjudgment itself is one of the most significant inherent risks. The “Release and Indemnity Agreement” section releases and indemnifies ITE from claims made against ITE. We do not seek this protection with regard to reckless or grossly negligent acts. We do seek protection from ordinary or simple negligence and all inherent or other risks, including misjudgment. We seek this protection because of the litigious climate in our society today. The line between inherent risks and negligence is not clear for all to see. The prospect of frivolous lawsuits, before judges and juries who may or may not understand the risks in the activities in which we participate in, is a real and significant threat to ITE. We are reserving the right to invoke these documents as we see fit. This is the result of circumstances that neither you nor ITE created. If you are uncertain about the meaning or significance of the Acknowledgment and Assumption of Risks & Release and Indemnity Agreement, you should consult an attorney before signing. Our hope is that you have confidence that ITE will strive to manage the risks we face and be fair in deciding our responsibility to you (if any) in the event of an accident or loss. If you do not have this confidence, you should not enroll or do activities at ITE. Please contact the Ironwood Tree Experience office with any questions you might have. Please review this Document carefully before agreeing to terms. All students, volunteers, instructors and guests (hereafter “student(s)”) must agree to the terms in this Document. For students under 18 years of age (hereafter “minor student”), parent or guardian (hereafter “parent”) and the student must agree to terms. ACKNOWLEDGMENT OF RISKS Although Ironwood Tree Experience has taken reasonable steps to provide you with appropriate equipment and skilled instructors so you can enjoy an activity for which you may not be skilled, we wish to remind you: field courses are not without risk. Certain risks cannot be eliminated without destroying the unique character of field courses. These are the same elements that contribute to accidental injury or illness, permanent trauma or death. We do not want to frighten you or reduce your enthusiasm for field activities, but we do think it is important for you to know in advance what to expect and to be informed of the inherent risks. Among these are the following: The nature of the activity itself (examples of inherent risks of activities include rock fall for rock climbing; drowning for boating; inclement weather for camping; etc); Misjudgments by self, others, or ITE employees; Acts of other participants, employees and agents of Ironwood Tree Experience, or other persons; in this activity; Latent or apparent defects or conditions in equipment or animals supplied by Ironwood Tree Experience, or other persons or entities; Use or operation, by myself or others, of equipment or animals supplied by Ironwood Tree Experience, or other persons or entities; Weather conditions; Contact with plants or animals; My own physical condition, or my own acts or omissions; Condition of roads, trails, waterways or terrain, and accidents connected with their use; First-aid, emergency treatment, or other services rendered; Consumption of food and drink. I (student and parent(s) of a minor student): Have read and understand the above information and all ITE information received. Have carefully read, reviewed, completed and signed the provided forms and paperwork. I acknowledge that the ITE staff is and has been available, should I have questions about the nature and physical demands of ITE programs and the risks associated with them. Understand that ITE cannot assure the student’s safety or eliminate these risks, and that all students share in the responsibility for their own safety. Understand that the information provided is not complete and that other unknown or unanticipated activities, risks, and outcomes may exist. Represent that I am voluntarily participating, with knowledge of the risks, and can do so without causing harm to myself or others. Assume and accept full responsibility for myself (son/daughter) for the inherent or other risks (both known and unknown) of these courses and for any injury, damage, death, or other loss me resulting from those risks. RELEASE AND INDEMNITY AGREEMENT In consideration of the services of ITE, staff, advisors, board members, teaching assistants, independent contractors, and all other persons or entities associated with it (collectively referred to as “ITE”), student and parent(s) of a minor student, acknowledge and agree as follows for the enrollment in a ITE course. Please read carefully. This Release and Indemnity Agreement contains a surrender of certain legal rights. I (adult students, or parent(s), for themselves, and for and on behalf of their participating minor student, agree as follows): to release and agree not to sue ITE, with respect to all claims, liabilities, suits, or expenses (hereafter “claim or claims”), asserted by or on behalf of me or my minor student, in any way arising from or related to with my, or my minor student’s enrollment or participation in ITE courses or activities, or use of ITE’s equipment or facilities. I understand that in signing this Document, I, my minor student, and anyone acting on my or my minor student’s behalf, surrender our respective rights to make a claim against ITE for any injury, damage, death or other loss suffered by me or my minor student. to defend and indemnify (“indemnify” meaning protect by reimbursement or payment including costs and attorneys fees) ITE, with respect to all claims, brought by or on behalf of me, my minor student, a family member, a co-participant or another party, in any way arising from or related to my, or my minor student’s participation in ITE activities or use of ITE equipment or facilities. This Release and Indemnity Agreement includes any losses caused or alleged to be caused, in whole or in part, by the negligence of PC (but not its gross negligence or reckless misconduct) and includes claims for personal injury, property damage, wrongful death, breach of contract, or otherwise. The following provisions apply to both the Acknowledgement and Assumption of Risks and the Agreement of Indemnity Release: ITE is authorized to obtain or provide emergency medical care, hospitalization, surgical or other medical care for me, or my minor student. I authorize ITE to administer emergency medical care and I understand that non-licensed medical providers may assist in providing such care. I (student and parent(s) of a minor student) agree that Arizona State law (without regard to its conflict of law rules) governs this document, and any dispute I have with ITE and all other aspects of my relationship with ITE, and that any mediation, suit or other proceeding must be filed or entered into only in Pima County, Arizona. I will attempt to settle any dispute through mediation before a mutually acceptable Arizona mediator. To the extent mediation does not result in a resolution the dispute will be submitted to binding arbitration through the American Arbitration Association, in Arizona. I (we) also agree to pay all costs for attorneys’ fees incurred by ITE in defending a claim or suit, if that claim or suit is withdrawn, or to the extent a court or arbitration determines that ITE is not responsible for the injury or loss. Any portion of this Document deemed unlawful or unenforceable shall not affect the enforceability of the remaining provisions and those remaining provisions shall continue in full force and effect.Media*I have read and agree to termsBy checking the above box, I hereby grant ITE and it’s professional partners (i.e. land agencies & non profit organizations) the right to take photographs and video of me, and to use the finished images in any legitimate uses that ITE or its professional partners deem proper (to the extent befitting the mission of ITE and its professional partners), including publications and websites. Furthermore, I relinquish and give to ITE all right, title and interest I may have in the finished pictures, negatives, reproductions and copies of the original prints, negatives, and videos. I also grant ITE the right to publish and/or release to the media information about myself and the activities I did with ITE or its professional partners. STUDENTS AND PARENTS OF A MINOR PARTICIPANT: I have carefully read, understand and voluntarily agree to this document and understand that I am surrendering certain legal rights. I acknowledge that it shall be effective and binding upon me, my participating minor student and other family members, and my heirs, executors, representatives and estate.