Registration Form
International Women Fly Fishers Golden Trout Pack Trip Rendezvous
July 14-18, 2010
Name: _____________________________________________Phone ___________________________________
Address:____________________________________________________________________________________
Email:__________________________________________Club Affiliation:______________________________
Dietary Restrictions____________ I am a beginner___Intermediate___ Advanced angler____.
Emergency Contact Name & Phone______________________________________________________________
I am a current IWFF member ____ I am a new IWFF member___
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Please complete and send to Rebecca Blair, 6404 Lagunitas Ave, El Cerrito, CA 94530 by April 30, 2010.
- This Registration Form. If you are not an IWFF member, include a check for $25 payable to IWFF.
- To reserve a spot, you must also complete and send to Frontier Pack Trains at PO Box 656, June Lake, CA 93529 by April 30, 2010.
- You must complete and send the remaining payment ($748 plus $100 wrangler gratuity = $848) and a Frontier Pack Train Registration Form http://www.frontierpacktrain.net/images/pdf/regform.pdf ) to Frontier Pack Trains at PO Box 656, June Lake, CA 93529 30 days prior to trip (June 13, 2010.)
WAIVER OF LIABILITY/PHOTOGRAPH RELEASE
In consideration of participating in International Women Fly Fishing activities and/or events, I hereby indemnify and hold harmless International Women Fly Fishers, its Officers, Board of Directors, Members and Agents from any and all liability for injury suffered by myself, or my minor children, arising from or connected with club activities and events. I assume all the risk for any injury received and agree to hold the International Women Fly Fishers free and harmless from any and all costs, expenses and attorneys fees incurred in connection with any injury, claim or demand brought thereon. I further agree to be bound by all terms and conditions set forth in the club by-laws and regulations.
I further hereby authorize and consent to the use and reproduction by International Women Fly Fishers of photographs taken of me, or my minor children, at the International Women Fly Fishers 2010 Mount Shasta Regional Rendezvous. Any such photographs may be used in the International Women Fly Fishers newsletter, web site, or any other International Women Fly Fishers publications, promotions or educational materials.
By signing this form you agree to all terms set forth regarding the waiver of liability/photograph release and the non refundable deposit and payment to Frontier Pack Trains. You also understand that although the trip is targeted for IWFF members, if the trip is not full by April 30th, 2010, any open spots may be offered to non-IWFF members, and that any pre- or post-trip lodging is not included in the above cost.
Signature_______________________________________________Date______________________ |