Application

Personal Contact Information
Full Name
Personal Address
Are you at least 21 years old?
Who will be paying for the workshop?
Training & Experience (Be Specific)
Reference 1
Name
Reference 2
Name
Miscellaneous
How did you hear about us?
Do you have a medical condition that we should be aware of?
Rules & Regulations of Learning Trade Secrets
TERMS    
     Upon acceptance, the applicant agrees to abide by Learning Trade Secrets, LLC Rules and Regulations. The applicant understands that all fees must be paid no less than 14 (fourteen) days prior to the beginning of instruction, and that no deduction or refund will be made less than 3 (three) days prior to instruction or for late arrival, early departure, or expulsion. Furthermore, the organization gives permission for the applicant to attend all functions and activities connected with the session, including any that may be held off-site. 


CONDITION RELEASE     
     I acknowledge that this workshop or activity may involve a test of a person’s physical and mental limits and may carry with it the potential for death, serious injury, and property loss. The risks may include, but are not limited to, those caused by terrain, facilities, temperature, weather, housing, condition of participants, equipment, vehicular traffic, actions of other people including, but not limited to, instructors, participants, volunteers, spectators, coaches, speakers, and workshop auditors. These risks are not only inherent to participants, but are also present for partners, volunteers, employees and independent contractors.


PHOTOGRAPHY  RELEASE 
     I hereby consent to be photographed and/or video graphed for Learning Trade Secrets' purposes. The resulting photography may be subsequently used without compensation to me by Learning Trade Secrets, or third parties for publications (including web sites), advertising, and/or publicity purposes at the discretion of the organization’s Marketing Director. I waive the right to inspect or approve the finished photography and/or publication use.


RELEASE OF LIABILITY
     IN CONSIDERATION OF MY PARTICIPATION IN A LEARNING TRADE SECRETS, LLC SPONSORED WORKSHOP, EVENT, OR ACTIVITY, I HEREBY ASSUME ALL OF THE RISKS AND RESPONSIBILITIES OF PARTICIPATING IN THIS WORKSHOP OR ACTIVITY, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault. I acknowledge that this Release of Liability will be used by Learning Trade Secrets, LLC workshop holders, sponsors, and organizers in which I may participate, and that it will govern my actions and responsibilities at said workshop. I hereby agree to not consume alcohol on workshop property. Should I consume alcohol off-site and go back to the workshop, I hereby agree to hold Learning Trade Secrets harmless for any accident, injury, or other event caused by my actions. I hereby consent to receive medical treatment, including but not limited to tests for drugs and/or alcohol, which may be deemed advisable in the event of injury, accident, and/or illness during this workshop.

ACCIDENT WAIVER

     In consideration of my application and permitting me to participate in this workshop, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:
(A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability and damage, including but not limited to, liability and damage arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this workshop, THE FOLLOWING ENTITIES OR PERSON: Learning Trade Secrets, LLC, its members, partners, officers, employees, volunteers, and independent contractors, in their personal representative capacity;

INDEMNITY

(B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned above from any and all liabilities, damages, or claims made as a result of participation in this workshop, whether caused by the negligence of release or otherwise. I acknowledge that Learning Trade Secrets, LLC and its members, partners, officers, employees, volunteers, representatives, property owners, independent contractors and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific event or activity on behalf of Learning Trade Secrets, LLC.

Do you understand and agree to the terms listed above? *