TRIP APPLICATION

IMPORTANT: Both sides of this form must be completed and signed, along with a $1000 non-refundable deposit per person in the form of a personal check or cashier’s check to secure your space on this trip.

If you are signing up fewer than 4 months (120 days) prior to your trip, full payment is due. For two or more people, please fill out one application for each person (you can photocopy the application if necessary).

Please print or type all information.

Name of Trip Date of Departure
Your Full Name (exactly as it appears on your passport)
Mailing Address
City State Zip
Home Phone Office Phone Cell Phone
Home Email Office Email Fax
Occupation Marital Status
Gender Age Height Weight Citizenship
Birth Date (Month/Day/Year) Birthplace
Passport Number Place of Issue Date of Expiration
Have you been on previous Peaks & Places trips? Which ones?
I am willing to share a double room withNonsmoker Smoker
I prefer a single room at supplemental cost (if available) Single tents may not be available.
Please describe your health
Dietary Restrictions (please describe)
In case of emergency please notify: Email
Address:
Telephone Cell Phone Relation

Please complete and sign the reverse side of this application; for two trip members, please photocopy both sides and fill out two applications.

You cannot participate on a Peaks & Places trip unless we have a signed application and a non-refundable $1000 deposit from every trip member. EFULLY: THIS IS A LEGALLY ENFORCEABLE WAIVER OF RIGHTS)

Release of Liability and Assumption of All Risks

(PLEASE READ CAREFULLY: THIS IS A LEGALLY ENFORCEABLE WAIVER OF RIGHTS)

The payment of a deposit represents acceptance by the tour member(s) of the following Release of Liability, Assumption of ALL Risks and Binding Arbitration.

ASSUMPTION OF RISKS

I, ______, acknowledge that I have voluntarily applied to participate in the trip designated on this application (or a trip which I may subsequently transfer to). I am voluntarily participating on the tour or expedition with knowledge that travel to the foreign countries and/or remote areas visited by this trip involves numerous risks and dangers including, but not limited to: the forces of nature; civil unrest; terrorism; roads, trails, hotels, vehicles, or other means of conveyance which are not operated or maintained at standards common in the United States; high altitude; accident or illness without access to means of rapid evacuation or availability of medical supplies; the adequacy of medical attention once provided; physical exertion for which I am not prepared; The hazards of walking on uneven terrain and slips and falls; being struck by rock fall, icefall or other objects dislodged or thrown from above; the use of climbing ropes and equipment; the forces of nature, including lightning, weather changes and avalanche; the risks of falling off the rock, mountain or into a crevasse; the risks of exposure to insect bites; the risk of altitude and cold including hypothermia, frostbite, acute mountain sickness, cerebral and pulmonary edema; my own physical condition, and the physical exertion associated with this activity, or negligence (but not willful or fraudulent conduct) on the part of Peaks & Places Travel LLC., or others. 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 voluntary participation. I HEREBY AGREE TO BE RESPONSIBLE FOR MY OWN WELFARE, AND ACCEPT ANY AND ALL RISKS OF DELAY, UNANTICIPATED EVENTS, ILLNESS, INJURY, EMOTIONAL TRAUMA, OR DEATH AND VERIFY THIS STATEMENT BY PLACING MY INITIALS HERE: ______.

RELEASE

I acknowledge that the cost of all Peaks & Places Travel trips is based upon Trip Participants executing this Release of Liability and Assumption of All Risks. Therefore, as lawful consideration for being permitted to participate on such trip(s), I hereby RELEASE AND DISCHARGE PEAKS & PLACES TRAVEL, LLC. AND IT’S AGENTS AND EMPLOYEES FROM AND AGAINST ANY AND ALL LIABILITY ARISING FROM MY PARTICIPATION IN THE TOUR OR EXPEDITION. I agree that this release shall be legally binding upon myself, all minors under the age of 21 traveling with me, my heirs, successors, assigns, and legal representatives; it being my intention to fully assume all the risk of travel and to release Peaks & Places Travel, LLC, from any and all liabilities to the maximum extent permitted by law. I understand that all applications are subject to acceptance by Peaks & Places Travel, LLC, and upon acceptance shall be deemed to have been entered into and to be performed in Ridgway, Colorado. In the unlikely event a legal dispute should arise involving any subject matter whatsoever, I agree that the following conditions will apply: (a) the dispute will be submitted to a neutral third-party mediator in Ridgway, Colorado with both parties splitting equally the costs of such a mediator. If the dispute cannot be resolved through mediation then (b) the dispute shall be submitted for binding arbitration through the Seventh Judicial District in Montrose, Colorado; (c) the dispute will be governed by Colorado law; and (d) the maximum amount of recovery to which I will be entitled under any and all circumstances will be the land cost of my trip with Peaks & Places Travel, LLC.

KNOWING AND VOLUNTARY EXECUTION

I have carefully read and fully understand the contents and legal ramifications of this agreement as well as all the conditions as stated under the heading “Terms and Conditions,” especially noting those regarding cancellation and refund policies, insurance, limitation of liability, and participant’s responsibility borne by trip participants. I understand this is a legally binding and enforceable contract and sign it of my own free will. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.

______

Signature of Applicant Dated:

PARENT OR GUARDIAN OF A MINOR I certify that I am the parent or legal guardian of the below named minor and hereby give my permission for this minor to participate in the trip or expedition. I agree individually and on behalf of my child to the terms above.

______

Name of minor if applicableSignature of Releasor

TERMS AND CONDITIONS

TRIP DEPOSIT

To ensure a spot on Peaks & Places Travel, LLC trip,send a personal check, money order or cashier's check for $1000 along with a completed Trip Application and signed Release of Liability and Assumption of All Risks waiver and signed Terms and Conditions form. This $1000 trip deposit is non-refundable. Planning our trips take a significant time and also have non-refundable costs as well.

FINAL PAYMENT

Final payment of the remaining balance is due 120 days before departure. Prices are quoted in US dollars and all payments must be made in US dollars by personal check, money order or cashier's check. All land payments submitted less than 30-days prior to departure must be paid by money order or cashier's check.Cost of tours may change if drastic fluctuations of foreign currencies occur.

CANCELLATION FEES AND POLICIES

At the time Peaks & Places Travel, LLC receives written notice that participant must cancel a trip the following fees apply:

  1. Canceling more than 90 days before departure, Peaks & Placeswill refund all money you have paid above the $1000 non-refundable trip deposit.
  2. Canceling 60-89 days prior to departure, Peaks & Placeswill refund 50% of what you have paid above the $1000 non-refundable trip deposit.
  3. Canceling 59 days or less, prior to departure, no refunds can be made.

Peaks & Places Travel, LLC reserves the right to cancel any trip at any time due to various reasons, which include (but are not limited to) political instability, natural disasters, or insufficient enrollment in our trip. If we cancel a trip prior to its start, we will refund your payments. Changes to a trip itinerary for any reason is not considered a cancellation, and no refunds will be made.

Peaks & Places Travel, LLC and our guidesreserves the right to decline to accept or to restrain from further participation any person it judges to be incapable of meeting the rigors and requirements of participating in the activities, or any person whose actions or deportment impede trip operation or the rights, welfare, or enjoyment of other trip members. A refund based on cost of unused land services is not possiblein such a case.

REFUNDS

No refunds will be given for unused hotel rooms, meals, sightseeing trips or trekking arrangements for any reason whatsoever. Land cost is quoted as a package and credits are not given for unused services.

Make sure you have trip cancellation insurance.

TRANSFERS

If participant transfers from one trip to another, Peaks & Places Travel, LLC must be advised 90 days prior to departure. The transfer fee is $50.00. Transfer requests less than 90-days before departure will be treated on an individual case basis and may be subject to the stated cancellation fees for that trip.

LAND COST INCLUDES

  • All in-country transportation except the use of taxis and domestic flights
  • Hotel accommodations (double occupancy)
  • All group camp supplies: tents, stoves, etc…
  • All meals except where noted in day by day itinerary
  • Cultural or Climbing Guides, cooks, pack animals, porters, Inca Trail permits and park fees
  • Assistant guides and trip leaders

LAND COST DOES NOT INCLUDE

  • International round-trip airfare to Lima or domestic flights inside Peru
  • Excess baggage charges
  • Travel and Medical Insurance of any kind
  • Medical costs including prescription medicines and International vaccinations
  • Airport taxes: Cuzco $10, Lima $30
  • Meals where noted in the Day by Day itinerary
  • Alcoholic beverages, laundry, room service and telephone calls
  • Personal clothing (recommended clothing list sent upon receipt of trip application & deposit)
  • Evacuation by helicopter or other conveyance or cost of hospitalization is not covered.
  • If any trip has to be delayed because of bad weather, road conditions, flight delays, sickness or other contingency for which Peaks & Places, Travel, LLC or its agents cannot make provision, the cost of delays are not included.

TIER PRICING

Peaks & Places Travel, LLC reserves the right to cancel any trip with fewer than 4 participants for economical reasons. In such case, a full refund of land Cost and Trip Deposit will be returned to the participant or the refund can be transferred to another Peaks & Places, LLC trip without a service charge. Peaks & Places, LLC is not responsible for additional expenses incurred by participants in preparation for the trip. Peaks & Places, LLC will run trips for groups smaller than the minimum number required, however, a supplementary charge will be assessed to operate the trip.

RESCUE / EVACUATION INSURANCE

Peaks & Places Travel, LLCREQUIRESall participants to have Rescue/Evacuation Insurance and Trip Cancellation Insurance to participate in all of our trekking and climbing trips.Since our costs are often not refundable, this should be purchased within 15-days of registering for one of our trips. Peaks & Places will not pay for any rescue/evacuation. Peaks & Places needs to have your policy number before you depart the USA.

Peaks & Places has two recommendations to satisfy the above requirements. These options may be found on the home page of our website under the button titled: Travel Coverage

Travel Guard: If you are participating in one of our trekking trips in Peru we highly recommend that you purchase the Great Outdoors Travel Insurance Plan offered by Travel Guard. The basic plan not only offers coverage for Trip Cancellation and Evacuation Coverage but also includes $2500 worth of lost baggage coverage. Just the base package alone provides everything we require at a very affordable price.

Global Rescue: If you are participating in one of our climbing expeditions in Peru or another country like Nepal we highly recommend Global Rescue coverage. Global Rescue offers worldwide rescue insurance at affordable prices. They do not provide and Trip Cancellation insurance however.

Baggage is carried entirely at owner’s risk. Peaks & Places Travel, LLC assumes no responsibility whatsoever for damage, loss or delay of property beyond its control.

-HEALTH INSURANCE:Peaks & Places Travel, LLC highly recommends that you have a health insurances policy that willcover emergency hospitalization abroad as well as domestically.

EQUIPMENT & BAGGAGE

Peaks & Places Travel, LLC provides all groups camping equipment including cooking gear, medical supplies, safety items, tents and mattresses. Participants are expected to bring a sleeping bag, clothing, and other items of a personal nature. Upon receipt of trip deposit, a detailed equipment list and airline baggage and weight restriction will be provided.

FOOD OR MEALS

When we are in towns and villages, we will be eating the local cuisine. In the mountains, all meals are prepared fresh daily with the highest possible degree of sanitation, by our camp cooks. We use fresh food bought in the local markets and create a variety of different dishes from pastas to stews, and even tasty desserts. We take great care to ensure that all drinking water is purified. If you have special dietary requirements, let us know in advance and we will try to accommodate you. However, special diets are not always available and cannot be guaranteed.

IMMUNIZATIONS

It is important to plan ahead and start getting your immunization shots at least TWO months before trip departure, so the shots can be sensibly spaced to allow maximum protection and minimum discomfort. The following inoculations are recommended: tetanus, typhoid and hepatitis A. To be sure that you get all the proper immunizations for the specific Peaks & Places Travel, LLC trip, you should consult your personal physician and/or the State Health Department.

MEDICAL INFORMATION

Our guides are certified in wilderness medicine, CPR, and are experienced in client care in remote high altitude locations. However, Peaks & Places Travel, LLC is not a medical facility and Peaks & Places Travel, LLC assumes no liability regarding your medical care.

You are responsible for your own medications, inoculations, and deciding whether you are physically able to participate in aPeaks & Places Travel, LLC trip. You should discuss your participation in this trip, and the dangers involved, with your physician.

PARTICPANT’S RESPONSIBILITIES

Peaks & Places Travel, LLC will work closely with you to help you select a trip that combines your interests and abilities. Trips are graded and described for your convenience. All of our expeditions and treks are physically demanding. Regardless of the skill level or experience needed, participants are held responsible for being in sufficiently good health to undertake the trip and prepared to handle extreme conditions, including cold, heat, and long tiring days.Participants are responsible for preparing for the trip by reading the detailed itineraries and pre-departure information sent by Peaks & Places Travel, LLC, and for bringing the appropriate clothing and equipment as advised. Peaks & Places Travel, LLC and its guides reserve the right to remove any member of our trips at any time if we do not believe they are ready for the rigors of the trip.

LIMITATION & LIABILITY

Peaks & Places Travel, LLC gives notice that services provided in connection with its itineraries, including transportation, hotel accommodations, restaurants are purchased from various independent suppliers who are not affiliated with Peaks & Places in any way. Although it endeavors to choose the best suppliers available, Peaks & Places Travel, LLC has no right to control their operations and therefore makes these travel arrangements upon the express condition that Peaks & Places Travel, LLC and its own agents and employees, shall not be liable for any delay, mishap, inconvenience, expense, irregularity, bodily injury or death to person, or damage to property occasioned through the conduct or default of any company or individual engaged in providing these services. Each of these passenger conveyance companies, tour companies, hotels, restaurants, etc., is subject to the laws of the state or country where the service is provided.

Peaks & Places Travel, LLC reserves the right to substitute both trip leaders and hotels from those listed in the itinerary without notice.

Peaks & Places shall not be liable for: (a) expenses such as additional hotel nights and meals not specified in the individual trip itineraries that may be required either en route, prior to, or following a trip, when caused by individual clients' travel arrangements, by airline scheduling or airline schedule changes, canceled flights, missed flight connections, or by other factors not underPeaks & Places control; (b) expenses incurred in recovering luggage lost by airlines, belongings left behind on a trip, or in shipping purchases or other goods home from abroad; (c) bodily injury or property damage for any reason, including but not limited to acts of God, weather, quarantines, strikes, civil disturbance, theft, default, detention, annoyance, changes in government regulations, terrorism, war, or failure of conveyance to arrive or depart as scheduled, etc., over which it (Peaks & Places Travel, LLC.) has no control.