Above the Clouds, Inc.
P.O. Box 388, Hinesburg, VT 05461
PHONE: (802)482-4848 or (800) 233-4499 | FAX: (802)482-5011 | EMAIL: info@aboveclouds.com

1. Name (as in passport)_____________________________________Occupation_____________________
Passport Number _____________________________Nationality_________________Age_____Sex_____
2. Name (as in passport)_____________________________________Occupation____________________
Passport Number _____________________________Nationality_________________Age_____Sex______
Street Address__________________________________________________________________________
City___________________________________State_____Zip__________e-mail_______________________
Phone (home)______________________(work)_____________________(fax)______________________
In case of emergency, please notify: Name_______________________________Relation_____________
Address____________________________________________________________Phone______________
I/We wish to book the following trek:_____________________________________Dates______________
Air Transportation
Unless we hear to the contrary, we will assume that you wish Above the Clouds, Inc. to prepare your airline tickets, including domestic space. It is usually to the passenger’s benefit to have domestic and international ticketing done together due to fare concessions. Please notify us if you would like to go early or extend your stay so that we can customize your air itinerary.
Please arrange air transportation from_________________________and return to____________________
I would like to use a credit card ([ ] AX [ ] MC [ ] VISA) to pay for the following:
[ ] air tickets [ ] application deposit [ ] full Land Cost when due
Card Number__________________________________________________Expiration Date____________
[ ] I am willing to share a double room [ ] Smoker [ ] Non-smoker [ ] Either
[ ] I prefer a single room and am willing to pay the supplemental cost
How did you hear of Above the Clouds, Inc.? _____________________________________________
Please describe your health and outdoor background ____________________________________________
_____________________________________________________________________________________
ASSUMPTION OF ALL RISKS
I, _________________________________________________, hereby acknowledge that I am aware that during the trip or vacation that I am participating in under the arrangements of Above the Clouds, Inc. and its agents or associates, certain risks and dangers may arise, including, but not limited to: the hazards of traveling in mountainous terrain, high altitude, the forces of nature, civil unrest, terrorism, travel by aircraft, boat, raft, automobile, bus, elephant or other means of conveyance, and accident or illness in remote regions without means of rapid evacuation or availability of medical supplies and facilities. 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 participation.
RELEASE OF LIABILITY
As lawful consideration for being permitted by Above the Clouds, Inc. to participate in such trips and activities, I hereby agree that I will not make a claim against Above the Clouds, Inc. or sue for bodily injury, death, emotional trauma, and/or property damage resulting from the acts of any employee, agent or contractor of Above the Clouds, Inc. as a result of my participation on this trip. I hereby release Above the Clouds, Inc. and its agents and employees from and against any and all liability arising out of or connected in any way with my participation on the trip.
The Assumption of All Risks and Release of Liability agreements are entered into on behalf of all members of my family, including any minors accompanying me. These agreements are binding on my heirs, legal representatives, and assigns. If any portion of these agreements is unenforceable, the remaining portions shall remain in full force and effect. Under no circumstances shall Above the Clouds, Inc. be liable to any trip participant for more than $500. All applications are subject to acceptance by Above the Clouds, Inc. Upon acceptance of my application, this agreement shall be deemed to have been entered into and to be performed at Burlington, Vermont and shall be construed according to the laws of the State of Vermont. In the unlikely event a legal dispute should arise involving any subject matter whatsoever, I agree that the dispute shall be settled by binding arbitration through the American Arbitration Assocation at Boston, Massachusetts. Should the arbitration provision be held unenforceable, I agree that any legal action shall exclusively be brought before the appropriate District Court of the State of Vermont in Burlington, Vermont or Federal Court in Burlington, Vermont.
I have carefully read and do agree to all the conditions as stated under the heading "Terms and Conditions" in this brochure, especially noting the policy on cancellations and refunds. I have also carefully read the above paragraphs, Assumption of All Risks and Release of Liability, as well as the paragraph which follows the latter, fully understand their contents, and agree to the same.
Signature of applicant/releasor ________________________________________________Date_________
Signature of applicant/releasor ________________________________________________Date_________
Signature of parent or legal guardian if applicant is under 21 _____________________________________
Please send an Above the Clouds brochure to:
Name ____________________________ Address _____________________________________________
Name ____________________________ Address _____________________________________________