1. Read the
following form carefully.
2. Print out the document.
3. If in agreement fill out the required information
including your signature.
4. Send it to our office by mail or fax it
to us at
(305) 675-0485 or (011)
(506) 241-6470.
I,
, will be participating in a study abroad
program in Costa Rica with the company ILASO
in the summer of 2007. Throughout the duration
of the program I will be participating in
many excursions to places such as Monteverde,
Volcán Arenal, and
Manuel Antonio. While I
am in this program I may be involved in
certain activities that could potentially
be dangerous. By choosing to engage in this
study abroad program I understand that I
am doing so at my own risk.
I hereby acknowledge that I am aware of
and understand the risks and dangers of
travel to, in, and around Costa Rica including,
but not limited to, the dangers to my own
health and personal safety posed by terrorism,
crime, violence, and disease. I hereby assume,
knowingly and voluntarily, each of these
risks and all of the other risks that could
arise out of or occur during my travel to,
from, in, or around Costa Rica.
With the intention of binding myself, and
my heirs, assigns, and legal representatives,
I hereby WAIVE AND RELEASE any and all rights
and claims for damages which I may have
against ILASO, and its officers, employees
and representative, for any and all property
damage and personal injury of whatever kind
suffered by me while participating in the
study abroad program, except for those arising
out of the willful misconduct, gross negligence
or intentional torts of the above parties.
International
Latin American Studies Organization
SJO# 5420 P.O. Box
025331 Miami, FL 33102-5331 U.S.A.
Or by e-mail: info@learningincostarica.com