The Fossil Cartel

Rockhounding Field Trip

Reservation Form

Saturday, June 14, 2008

Agates, Jaspers, Calcite, and Zeolites

at the Oregon Coast

Name:  ________________________________

Address:  ______________________________

City: __________________________________

State:  _____  Zip:  _______________________

Phone: (________) _______________________

E-mail:  ________________________________

Please read the following disclosure and sign:

Participants must be 18 years of age or accompanied by a legal guardian, provide their own transportation to/from field trip point(s) of departure and provide field trip payment in full prior to departure.  The undersigned recognizes the potential for hazards not under the control of the field trip guide or of The Fossil Cartel, Inc., and assumes the risk of any and all loss of, or damage to, property and or bodily injury, including death, however caused, resulting from, arising out of or in any way connected to this field trip.  The undersigned indemnifies and holds harmless the field trip guide and The Fossil Cartel, Inc. from any loss, liability, damage or costs which may be incurred due to acts or omissions of any trip participant.  I have read and fully understand the conditions of participating in this field trip.  I am aware that this is a legal release of liability and contract between myself and the field trip guide and between myself and The Fossil Cartel, Inc.  I sign here of my own free will.

Signature:  _____________________________________________________

Legal Guardian (if under age 18): ___________________________________

Date:  _____________

Please mail this form by June 6, 2008.

If registering after June 6, you must bring this form with you on the day of the trip -- and you also need to call us to reserve a spot: 503-228-6998

Mail to :

Rockhounds
The Fossil Cartel
Pioneer Place #1440
340 SW Morrison
Portland, OR 97204