WaiverReleaseForm.pdf -

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MYBHUTAN, LLC AGREEMENT TO PARTICIPATE WITH WAIVER AND RELEASE OF LIABILITY DISCLAIMER: MYBHUTAN, LLC, ITS MEMBERS, OFFICERS, DIRECTORS, EMPLOYEES, AGENTS, VOLUNTEERS AND ALL OTHERS INVOLVED IN THE BHUTAN TRAVEL EXPERIENCE ARE NOT RESPONSIBLE FOR ANY INJURY (OR LOSS OF PROPERTY) TO ANY PERSON SUFFERED WHILE TRAVELING TO/FROM OR IN BHUTAN OR IN ANY OTHER WAY INVOLVED WITH MYBHUTAN, LLC, FOR ANY REASON WHATSOEVER, INCLUDING NEGLIGENCE. In consideration of my being allowed to participate in MyBhutan, LLC travel experiences, I hereby release and covenant not-to-sue MyBhutan, LLC, its members, officers, directors, employees, agents, volunteers and all others involved in the travel experience, from any and all present and future claims for property damage, personal injury, or wrongful death, arising as a result of my participating in MyBhutan, LLC travel experiences, wherever, whenever, or however the same may occur. I hereby voluntarily waive any and all claims, both present and future, that may be made by me, my family, estate, heirs or assigns. Further, I understand that travel to, from and in Bhutan may be hazardous and involve the risk of injury, sickness and possibly death, as well as damage to property. I understand that I may need to travel in very remote areas, risk violence from crime, war, terrorism, political unrest and other dangers, and may be exposed to food and water-borne diseases and to disease from other carriers. I understand also that medical facilities abroad may not be of the quality of medical facilities in my home country and that participation in the travel experience may involve being in regions that are remote from medical assistance. I am voluntarily participating in this travel experience with knowledge of the danger involved. I understand that this waiver is intended to be as broad and inclusive as permitted by the laws of the State of Florida in the United States and agree that if any portion is held invalid, the remainder of the waiver will continue in full legal force and effect. I further agree that the venue for any legal proceeding shall be in the State of Florida. This is to certify that I, the participant (or in the case that the participant is a minor, I refers to the parent/guardian with legal responsibility for the minor son or daughter), have indeed read the above agreement to participate with waiver and release of liability and agree to the release of all parties named herein, and for myself, my heirs, assigns, and next of kin, I release and agree to hold harmless MyBhutan, LLC and all other parties named herein from any and all liabilities incident to my (or my minor son’s/daughter’s) participation in the Bhutan travel experience, EVEN IF ARISING FROM NEGLIGENCE, to the fullest extent permitted by law. Name of Participant: ______________________________________________ Signature of Participant: ___________________________________________ OR if participant is a minor: Name of Participant: ______________________________________________ Name of Parent/Guardian: __________________________________________ Signature of Parent/Guardian: _______________________________________ 1 MYBHUTAN TRAVEL AFFILIATE AGREEMENT CONFIDENTIAL