National Parks of the Pacific Northwest - EARLY BOOKING SAVINGS! - UW-Whitewater

 
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National Parks of the Pacific Northwest - EARLY BOOKING SAVINGS! - UW-Whitewater
9 DAY HOLIDAY

                                                             EARLY
                                                           BOOKING
                                                           SAVINGS!
     National Parks of                                     Cal l for Details!

   the Pacific Northwest
featuring Mount Rainier and Olympic Mountains National Parks

             Tour Dates: September 9th – 17th, 2021
National Parks of the Pacific Northwest - EARLY BOOKING SAVINGS! - UW-Whitewater
National Parks of
the Pacific Northwest
9 Days • 13 Meals Explore the Pacific Northwest
from Seattle’s vibrant waterfront to the English charm of
British Columbia’s capital, Victoria. Along the way, see
the deep, dark waters of Puget Sound, the majesty of
Mount Rainier and the native culture at Tillicum Village.
TOUR HIGHLIGHTS
4 13 Meals: 8 breakfasts, 1 lunch and 4 dinners
4 Round trip airport transfers
4 Spend 5 nights in Tacoma, Washington
4 Tour the Museum of Glass featuring a “hands on” session and the
  impressive Chihuly Bridge of Glass
4 Visit LeMay-America’s Car Museum, the largest collection of classic
  and vintage automobiles in the world
4 Cruise to Blake Island for the ultimate Northwest Native American
  experience at Tillicum Village
4 Open-air tram through Northwest Trek Wildlife Park to see American
  bison and Roosevelt elk
4 Sightseeing in Mount Rainier National Park with its Douglas firs and
  icy glaciers
                                                                                                                     Plenty of time to explore Seattle, Washington
4 Narrated city tour of Seattle including Pioneer Square Historic Park
  and free time for lunch in Pike Place Market
4 Visit the Museum of Flight viewing the historic aircraft, Space Gallery
  and Boeing’s original Red Barn factory                                                            DAY 1 – Travel to Tacoma, Washington
4 Enjoy a tasty dinner at the Emerald Queen Casino                                                  Arrive at Seattle’s International Airport and transfer to your hotel in
4 Ferry to Victoria, known for its English flavor, double-decker buses,                             Tacoma. Tonight, your Tour Manager hosts a welcome dinner.
  Tudor-style buildings and gardens                                                                 Meal: D
4 Discover world-famous Butchart Gardens with its ornate landscaping
  and superb Italian, Japanese, and rose gardens                                                    DAY 2 – Museum of Glass and
4 Tour Olympic National Park featuring Lake Crescent and the beautiful                              LeMay-America’s Car Museum
  Olympic Mountains                                                                                 Today starts with a unique “hands on” session in a Tacoma “glass
4 $45 in Mayflower Money                                                                            hot shop,” where you’ll design and make your own art glass pieces.
                                                                                                    Then, visit the renowned Museum of Glass and cross the Chihuly
                                                                                                    Bridge of Glass filled with the artist’s glass works. Later, explore the
                    BRITISH COLUMBIA                                                                massive collection of classic vehicles at the spectacular LeMay-
                                              Victoria
                         CANADA                                                                     America’s Car Museum nearby. After lunch, groups will switch
                               Strait of
                             Juan de Fuca                                                           places so that everyone will enjoy identical opportunities. Meal: B
                                              Sequim
                          Port Angeles    3
                                                            Port Townsend

                            Olympic                                                                 DAY 3 – Blake Island Cruise and Tillicum Village
                          National Park
                                                                  Port Gamble
                                                                                                    Enjoy some free time this morning before boarding an Argosy Cruise
                                                             Bainbridge                             vessel and set sail for Blake Island for the ultimate Northwest Native
                                                                        Seattle
                                                                                                    American experience. At Tillicum Village immerse yourself in the
                Pacific
                Ocean
                                                                                                    culture, history and traditions of Northwest Native American tribes
                          WASHINGTON                     Tacoma
                                                                  5                                 with a fire-roasted meal, native storytelling show and traditional
                                                                                                    longhouse with Coast Salish totems. Meals: B, L
                                                                                    Mount Rainier
                                                                                    National Park
    1   Overnight                                                 Eatonville

        Visit
                                                                                                    DAY 4 – Northwest Trek Wildlife Park and
                                                                                  Paradise          Mount Rainier National Park
        Tour Route
                                                                                                    At the Northwest Trek Wildlife Park, take an open-air tram tour
                                                                                                    through its “free-roaming area” to view the numerous American
HOTEL ACCOMMODATIONS                                                                                bison, Roosevelt elk, caribou and moose found here. One of the
Days One through Five – Hotel Murano, Tacoma, Washington                                            nation’s premier scenic attractions, Mount Rainier stands at 14,410
Days Six through Eight – Red Lion Hotel, Port Angeles, Washington
National Parks of the Pacific Northwest - EARLY BOOKING SAVINGS! - UW-Whitewater
Museum of Flight, Seattle, Washington                                  Inner Harbor, Victoria, British Columbia, Canada

feet and is the focal point of the park. Fields of brilliant           landscaping and superb Italian, Japanese and rose gardens. Before
wildflowers, forests of giant Douglas fir, icy glaciers and peaceful   returning to Port Angeles this evening, dinner is included at the
valleys teeming with wildlife are found here. Meal: B                  Victoria Harbour House Restaurant. Meals: B, D

DAY 5 – Seattle City Tour and Museum of Flight                         DAY 8 – Olympic National Park
A guided tour of Seattle includes the downtown, Pioneer Square         Today, embark on a scenic drive through extraordinary Olympic
Historic District, Waterfront Park, views of the Space Needle and      National Park. See the beautiful Lake Crescent, panoramic vistas of
the Lake Washington Ship Canal and Locks. Following free time for      the towering Olympic Mountains and the Strait of Juan de Fuca
lunch and browsing at famed Pike Place Market, you’ll spend the        from the mile-high Hurricane Ridge Visitor Center. Meals: B, D
afternoon viewing the numerous displays and historic aircraft, Space
Gallery and Boeing’s original Red Barn factory at Seattle’s            DAY 9 – Return Home from Seattle
outstanding Museum of Flight. Tonight, enjoy a tasty dinner at the     Crossing Puget Sound via the Washington State Ferry from
Emerald Queen Casino. Meals: B, D                                      Bainbridge Island, arrive at Seattle’s Sea-Tac Airport for flights out
                                                                       after 1:00 p.m. Meal: B
DAY 6 – Olympic’s Port Cities and Sequim Lavender Farm
Cross the Tacoma Narrows Bridge to the Olympic Peninsula and
visit the charming village of Port Gamble before coming to the
Historical Society Museum in historic Port Townsend, with its
handsome Victorian-era homes. This afternoon, tour a colorful
lavender farm in the Sequim area before coming to your waterfront
hotel. Meal: B

DAY 7 – Ferry to Victoria, BC and Butchart Gardens
Have your passports handy this morning as you cross the Strait of
Juan de Fuca via the spacious MV Coho ferry en route to Vancouver
Island. Here, picturesque Victoria maintains a delightful English
flavor, spiced with red double-decker buses, Tudor-style buildings
and immaculate gardens. See the Parliament Buildings, Beacon Hill
Park, Christ Church Cathedral and the impressive Empress Hotel.
Discover why Butchart Gardens are world-famous for ornate                                       Totem pole on Blake Island
National Parks of the Pacific Northwest - EARLY BOOKING SAVINGS! - UW-Whitewater
EARLY
              G
    BOOKINS!
    SAVINDeGtails!
                                                                                                                                                                           Summer tranquility in the Olympic Mountains

             r
      Call fo
                                                                                                                  Travelers Protection Plan (TPP) – $200 per person (optional)
                                                       PER PERSON                    SINGLE                       This nonrefundable fee waives all cancellation fees when we are notified of cancellation one day before
                                                                                                                  the tour departs. If you must leave the tour early due to personal illness, illness or death of a member
              2021 DEPARTURE                           TWIN ROOM                     ROOM                         of your immediate family, TPP guarantees full refund for any unused services after the departure of the
                                                                                                                  tour. Other benefits include medical expenses for illness and injury, emergency transportation, 24 hour
                     September 9                               $3,899                add $1,349                   hot line, and lost or stolen baggage assistance. Return air transportation is included ONLY if your air
                                                                                                                  tickets were provided by Mayflower Cruises & Tours. If you purchase the optional Travelers Protection
                                                                                                                  Plan (TPP), you will be refunded all payments, including deposit amount, less the TPP premium amount.
     Pricing includes Home or Local Pickup/Drop off to/from Chicago O’Hare                                        Cancellation Charges Without Traveler’s Protection Plan (TPP)
        International Airport, Round trip airfare, inclusive of taxes and fuel                                    • 61 days and more – deposit amount
                                                                                                                  • 60 – 31 days – 20% of the tour cost
                     surcharges which are subject to change.                                                      • 30 – 15 days – 30% of the tour cost
                                                                                                                  • 14 – 1 day prior – 40% of the tour cost
                         Deposit is due within 5 days of reservation:                                             • Day of departure or early departure from tour – 100% of the tour cost
                                                                                                                  No refund on unused portion
                            $200 per person without Travel Protection
                                                                                                                  Exclusions: Mayflower Cruises & Tours reserves the right to alter its refund and cancellation policy when a
                      $400 per person including the Travelers Protection Plan                                     substantial amount of cancellation or postponement of travel is attributable to: conditions resulting from an
                               Final payment is due July 9th, 2021                                                act of God, natural or man-made disaster, fire, government action, civil disorder, war, hostilities between nations,
                                                                                                                  or unavailability of transportation through no fault of Mayflower Cruises & Tours.

   Air itineraries may not be available until documents are received. Air seats are assigned by the airline for
   the entire group. Seat changes can only be attempted upon receipt of tickets and documents at which
   time availability may be limited. If specific seat assignments are vital to your reservation, we recommend
                                                                                                                        FOR RESERVATIONS OR INFORMATION CONTACT:
   individual air reservations rather than booking air with the group.
                                                                                                                                        Mayflower Cruises & Tours
                                        TOUR ACTIVITY LEVEL                                                                              Group Sales Department
                                           1 2 3 4 5                                                                                              800-728-0724
                                        EASY                         ENERGETIC                                         Please mention the University of Wisconsin - Whitewater

                                                                                                                          UW-Whitewater Contact - Amy Oeding
                                         National Tour Association
                                                                                                                                                  262-472-7033
                                                                                                                                                   oedinga@uww.edu
revised 02-14-2019
National Parks of the Pacific Northwest - EARLY BOOKING SAVINGS! - UW-Whitewater
2021 NORTH AMERICA
                                     Terms and Conditions
Payment Information: Listed below is a schedule of deposit and final           North America Tours
payment due dates. You will note that the first category includes an            • 61 days or more: Deposit Amount
optional Travelers Protection Plan (TPP) which is to be paid within five        • 60 to 31 days prior: 20% of tour cost
business days after your reservation. Please see “Travelers Protection Plan     • 30 to 15 days prior: 30% of tour cost
(TPP)” section on the next page for further explanation of this benefit.        • 14 to 1 day prior: 40% of tour cost
                                                                                • Day of departure or early departure from tour: 100% of tour cost
DEPOSIT SCHEDULE – Land tour price up to $3,500                                 • No refund on unused portions of the tour

Land Tour with Air*            Deposit Per Person          Final Payment       Alaska Adventure Cruise, Hawaiian Cruising in Paradise,
• With TPP Coverage                  $400                     60 Days          Canadian Rockies by Rail, New England & Canada Autumn Cruise
                                                                                 • 121 days or more: Deposit Amount
• Without TPP Coverage               $200                     60 Days
                                                                                 • 120 days until day of departure: 100% of the tour cost
                                                                                 • No refund on unused portions of the tour
Land Tour Only**               Deposit Per Person          Final Payment
• With TPP Coverage                  $350                     60 Days          Exclusions: Mayflower Cruises & Tours reserves the right to alter its Refund
• Without TPP Coverage               $200                     60 Days          and Cancellation Policy when a substantial amount of cancellation or
                                                                               postponement of travel is attributable to: conditions resulting from an act
DEPOSIT SCHEDULE – Land tour price from $3,501 and up                          of God, natural or man-made disaster, fire, government action, civil disorder,
                                                                               war, hostilities between nations, or unavailability of transportation through
Land Tour with Air*            Deposit Per Person          Final Payment       no fault of Mayflower Cruises & Tours.
• With TPP Coverage                  $449                     60 Days
• Without TPP Coverage               $200                     60 Days          Air Services: Airfare may be purchased through Mayflower for travel
                                                                               originating in the United States. By using Mayflower’s air services, you
Land Tour Only**               Deposit Per Person          Final Payment       accept that Mayflower is only acting as your agent and is not responsible
                                                                               for any accident, death, personal injury, illness, property damage, delay or
• With TPP Coverage                  $400                     60 Days
                                                                               other monetary loss or expense of any nature that may arise directly or
• Without TPP Coverage               $200                     60 Days          indirectly out of any act of God, or any actions or default of any carrier.
                                                                               Mayflower is not liable for, and does not assume responsibility or accept
DEPOSIT SCHEDULE: Alaska Adventure Cruise, Hawaiian Cruising in                claims with regards to any losses incurred due to cancellation of flights or
Paradise, Canadian Rockies by Rail, New England & Canada Autumn Cruise         change in flight schedule resulting in additional expenses to you, even
Land/Cruise Tour with Air*     Deposit Per Person          Final Payment       when the air services are purchased through Mayflower.
• With TPP Coverage                  $799                     120 Days
• Without TPP Coverage               $400                     120 Days         Tour Price Includes: All motorcoach transportation noted in the tour
                                                                               itinerary, round trip airport transfers on the tour departure and return dates
Land/Cruise Tour only**        Deposit Per Person          Final Payment       (only), services of the Tour Manager and driver, lodging, sightseeing, taxes,
• With TPP Coverage                  $739                     120 Days         admissions, gratuities for bellmen and waiters for included meals, as well as
• Without TPP Coverage               $400                     120 Days         future travel credits. Included meals are clearly noted in the touring
                                                                               description. Air transportation is available upon request, at additional cost,
             **Land tour price is based on twin occupancy rate                 for United States and Canada Tours. For travelers purchasing their own air,
                                                                               airport transfers are included provided their flight arrival and departure
Refund and Cancellation Policy: All payments for land, air and train           times meet the time frames suggested in the brochure.
arrangements (ticketed by Mayflower Tours) will be refunded when
cancellations are more than 90 days prior to departure less the deposit        What is Not Included on the Tours: The land price of your tour does not
amount, which is non-refundable, unless otherwise noted below. If you          include airfare to the tour departure point; excess luggage charges; items of
purchase the optional Travelers Protection Plan (TPP), you will be refunded    a personal nature; meals not included on the itinerary; sightseeing
all payments, including the deposit amount, less the TPP premium amount.       attractions listed as “optional excursions” and gratuities to the full time Tour
                                                                               Manager, motorcoach driver, all airport skycaps, van or limo drivers and local
*Exception: If you purchased non-refundable airline tickets from               guides.
Mayflower Cruises & Tours, the TPP does not provide a refund for the airline
tickets in the event of a cancellation or a return transportation benefit if   Airline Security Measures: The Transportation Security Administration
you must return home early. You will only be charged the TPP premium for       requires that travelers provide their name exactly to their airline as it
the land tour instead of the premium for land tour with air. Should you        appears on the passport or a government issued I.D.(such as a drivers
choose not to purchase our Travelers Protection Plan, the following per        license) to be used while traveling, along with their date of birth and gender
person cancellation charges will be assessed for all tours and optional        when making reservations to fly within the U.S. When making your flight
excursion costs:                                                               reservations through Mayflower Tours, you will be asked for this information
                                                                               by our staff. Due to airline security measures, your photo I.D. or passport
                                                                               must match your airline ticket name and your tour reservation name or you
                                                                               may be denied aircraft boarding.

                                                                               Passport & Visas for Canada and Mexico: Each U.S. citizen must have a
                                                                               valid passport for entry into Canada or Mexico. No other documents will be
                                                                               accepted. Expiry date of passports should be at least six months after the
                                                                               return date of tour. If you don’t have a passport, call our office and we’ll tell
                                                                               you how to apply for one. Holders of non-U.S. passports should contact
                                                                               their nearest consulate and inquire about the necessary passport or visa
                                                                               documentation required for entry into the countries visited.
National Parks of the Pacific Northwest - EARLY BOOKING SAVINGS! - UW-Whitewater
2021 NORTH AMERICA
                         Travelers Protection Plan
       Our Travelers Protection Plan consists of a Cancellation Fee Waiver combined with Travel Insurance Benefits.

PART A - CANCELLATION FEE WAIVER (CFW)
Should you have to cancel your tour or interrupt your tour en route, we have added a non-refundable Travelers Protection Plan
(TPP) in our deposit schedule. If you do not wish to purchase this protection, simply deduct the amount from your deposit. This
non-refundable fee waives all cancellation fees and penalties, provided we are notified of the cancellation one day before your tour
departs. While on tour, if a passenger must leave early due to a personal illness, illness or death of a member of the immediate
family, the purchase of the Travelers Protection Plan (TPP) guarantees full refund for any unused services (including purchased
optional excursions) after the departure of the tour. Handling of return air transportation is included if your airline tickets were
provided by Mayflower Cruises & Tours. *Exception: If you purchased non-refundable airline tickets from Mayflower Tours, the TPP
does not provide a refund for the airline tickets in the event of a cancellation or a return transportation benefit if you must return
home early. You will only be charged the TPP premium for the land tour instead of the premium for land tour with air.

Exclusions
Mayflower Cruises & Tours reserves the right to alter its refund and cancellation policy when a substantial amount of cancellation
or postponement of travel is attributable to: conditions resulting from an act of God, natural or man-made disaster, fire,
government action, civil disorder, war, hostilities between nations, or unavailability of transportation through no fault of
Mayflower Cruises & Tours.

PART B - TRAVEL INSURANCE BENEFITS
In addition to the Part A - Cancellation Fee Waiver, this plan also provides the following travel insurance benefits. These Part B
Benefits are offered and administered by Trip Mate Insurance Agency, Inc., are underwritten by the insurance carriers listed below
and are subject to the terms, conditions and exclusions of the policy:

           • $25,000 Accidental Death & Dismemberment
           • $500 Trip Delay (Up to $100 Per Day)
           • $25,000 Medical Expense/Emergency Evacuation
           • 24 Hour Worldwide Assistance Service
           • $2,000 Baggage / Travel Documents
           • $500 Baggage Delay (Up to $100 Per Day)

Certain exclusions and limitations apply and are detailed in the Description of Coverage Brochure which will be enclosed with
your deposit receipt and is also available to you, upon request, at any time prior to your purchase of the plan. For example,
coverage does not apply to; suicide, normal pregnancy, war or any act of war, mental or nervous disorders. A Traveling Companion
is defined as a person booked to share accommodations in the same room or cabin with you during your trip. Sickness or Injury
must require care by a Physician and must commence while insurance is in force for you. This plan does not cover a loss that
results from an illness, disease, or other condition (of you, an Immediate Family Member, Traveling Companion or Business
Partner), event or circumstance which occurs at a time when this plan is not in force for you.

Part B Travel Insurance is underwritten by Monumental General Casualty Company (all states except as otherwise noted) &
Monumental Life Insurance Company (AK, KS, ME, MA, NH, NJ, NC, WA, WI, WY) & J.C. Penney Casualty Insurance Company (CO, MI,
MN, NY, VT).

  For complete details on the protection plan refer to the Description of Coverage Brochure enclosed with your deposit receipt.

                     Important! The Travelers Protection Plan must be purchased by the time
                          of initial payment and may not be purchased at a later date.
National Parks of the Pacific Northwest - EARLY BOOKING SAVINGS! - UW-Whitewater
Tour: _______________________________________________
      National Parks of the Pacific Northwest                                         Departure Date: _____________
                                                                                                      September 9th, 2021

Group Name: ________________________________________
            University of Wisconsin Whitewater                                        Group Number: ______________
                                                                                                    1027380

For Reservations Contact: ___________________________________________________________
                          Mayflower Cruises & Tours Group Sales Department
                                              ___________________________________________________________
                                              800-728-0724 or
                                              ___________________________________________________________
                                              UW- Whitewater: Amy Oeding
                                              ___________________________________________________________
                                              262-472-7033

                      Make Checks Payable To: ________________________________
                                              Mayflower Cruises & Tours                                    ___ Single     ___ Twin      ___ Guaranteed Share
                      Mail Deposit To: ________________________________________
                                       Mayflower Cruises & Tours
                                                                                                           o One Bed       o Two Beds
                      _____________________________________________________
                      650 Warrenville Rd Suite 500
PAYMENT INFORMATION

                      _____________________________________________________
                                                                                                           Deposit Amount: $_________________
                      Lisle IL 60532
                      Mail Final Payment To: __________________________________
                                                                                                                            200.00pp
                                                                                                           Travel Protection Plan: $____________
                                             SAME AS ABOVE
                      _____________________________________________________
                                                                                                                                    200.00pp
                                                                                                           Total Amount Enclosed: $____________
                      _____________________________________________________
                      Credit Card #: _________________________ Exp. Date: _______
                                                                                                           Final Payment Due By: _____________
                      Cardholder Name & Billing Address:
                                                                                                                                 July 9th, 2021

                      _____________________________________________________
                      _____________________________________________________
                      _____________________________________________________

          IMPORTANT: Please print your name EXACTLY as it appears on Real ID or Passport. Name corrections, after final
                           payment due date or after tickets have been issued, will result in additional fees being assessed

                      Salutation: ____ First: ________________ Middle: ________________ Last: ________________ Suffix: ____ Nickname: ___________
YOUR INFORMATION

                           (Mr., Mrs., Rev)                            (Please print EXACTLY as it appears on Passport)         (Jr., Sr.)

                      Address: _______________________________________ City: __________________________ State: ______ Zip Code: __________

                      Phone: _________________________ Cell: _________________________ Email Address: _________________________________

                      Date of Birth: _________________________ Gender: o Male           o Female

                      Emergency Contact: ______________________________________ Relationship: __________________ Phone: _________________

                      Salutation: ____ First: ________________ Middle: ________________ Last: ________________ Suffix: ____ Nickname: ___________
                           (Mr., Mrs., Rev)                            (Please print EXACTLY as it appears on Passport)         (Jr., Sr.)
ROOMING WITH

                      Address: _______________________________________ City: __________________________ State: ______ Zip Code: __________

                      Phone: _________________________ Cell: _________________________ Email Address: _________________________________

                      Date of Birth: _________________________ Gender: o Male           o Female

                      Emergency Contact: ______________________________________ Relationship: __________________ Phone: _________________

                      Please advise your departure airport for this tour: ________________________________________ o Mayflower Air o Writing Own Air
National Parks of the Pacific Northwest - EARLY BOOKING SAVINGS! - UW-Whitewater
Agreement for Assumption of Risk, Indemnification, Release, and Consent for Emergency Treatment
                   University of Wisconsin – Whitewater Alumni Association
                         National Parks of the Pacific Northwest Tour
                                     September 9–17, 2021
I, _________________________________ (print name), age _______, desire to participate voluntarily in the University of
Wisconsin – Whitewater Foundation, Inc. and Alumni Association activities and related trips.

I UNDERSTAND THAT I AM BEING ASKED TO READ EACH OF THE FOLLOWING PARAGRAPHS CAREFULLY.
I UNDERSTAND THAT IF I WISH TO DISCUSS ANY OF THE TERMS CONTAINED IN THIS AGREEMENT, I MAY
CONTACT GREG RUTZEN, UW-WHITEWATER VICE CHANCELLOR OF UNIVERSITY ADVANCEMENT, AT (262)
472-3182.

Assumption of Risks:

I understand that not all risks can be foreseen and there are some risks which are unpredictable. I understand that certain
inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. I am aware of the risks of participation,
which include, but are not limited to, the possibility of physical injury, fatigue, bruises, contusions, broken bones, concussion,
paralysis, and even death. I understand that the University and the Foundation have advised me to seek the advice of my
physician before participating in any strenuous physical activity. I understand that I have been advised to have health and
accident insurance in effect and that no such coverage is provided for me by the University or the Foundation. I know,
understand, and appreciate the risks that are inherent in the above-listed programs and activities. I hereby assert that
my participation is voluntary and that I knowingly assume all such risks.

Signature: _________________________________________________ Date: ______________________

Signature of Parent or Guardian
(If Participant is under 18*): __________________________________Date:______________________

Hold Harmless, Indemnity and Release:

In consideration of my participation in these activities, I, for myself, spouse, heirs, personal representatives, estate or assigns,
agree to defend, hold harmless, indemnify and release the University of Wisconsin-Whitewater and the UW-Whitewater
Foundation, Inc., and their officers, directors, employees, agents, volunteers, and all others who are involved, from and against
any and all claims, demands, actions, or causes of action of any sort on account of damage to personal property, or personal
injury, or death which may result from my participation in the above-listed program. This release includes claims based on the
negligence of the University of Wisconsin-Whitewater and/or the UW-Whitewater Foundation, Inc., and their officers,
directors, employees, agents, and volunteers, but expressly does not include claims based on their intentional misconduct or
gross negligence. I understand that by agreeing to this clause I am releasing claims and giving up substantial rights,
including my right to sue.

Signature: _________________________________________________ Date: ______________________

Signature of Parent or Guardian
(If Participant is under 18*): __________________________________Date:______________________

Consent for Emergency Treatment:

I authorize the University of Wisconsin-Whitewater and/or the UW-Whitewater Foundation, Inc. and its designated
representatives to consent, on my behalf, to any emergency medical/hospital care or treatment to be rendered upon the advice
of any licensed physician. I agree to be responsible for all necessary charges incurred by any hospitalization or treatment
rendered pursuant to this authorization.

Signature: _________________________________________________Date:______________________

Signature of Parent or Guardian
(If Participant is under 18*): __________________________________Date:______________________

*If your son, daughter or ward will be under 18 while participating in University of Wisconsin-Whitewater activities and related trips, it is our policy
to request your agreement to the above terms, on behalf of your minor son, daughter or ward.
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