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Registration Form HGH Portland, 2007 NAME _______________________________________________________________ Hot Glass Horizons Portland 2007 is a 4-day program Oct. 25 - 28, 2007. Mail or fax (503-538-6527) in your registration form. If you prefer, you can also register by phone at (503) 538-5281. If you have any questions about the classes or are a beginner, please don’t hesitate to call or register by phone. I would like to attend the following classes: ____/___ - Thu. - Thursday Oct. 25th TUITION: The tuition fee of $795.00 includes your choice of three full-day classes, two dinners, the use of class equipment and supplies. Half-day Lecture / Demo classes - $125 (Thursday, Oct. 25th ) ________ Enclosed is check # _________ for $ _____________ ________Please use my VISA, MASTER CARD, or AMERICAN EXPRESS _______________________________________________ Account number The full tuition must accompany this form to assure your specified class choices. Classes can not be held without receipt of full payment. Cancellations can only be accepted prior to October 1st, 2007 with a $100.00 processing fee. PHOTO RELEASE Hot Glass Horizons 2007 will have video and still cameras documenting some of its activities. We need your permission to take and use your pictures. Release and Waiver of Liability, Assumption of Risk and Indemnity Agreement By signing this Agreement, you are giving up certain legal rights, including the right to recover damages in case of injury, death or property damage. I _______________________________________(hereinafter the "Undersigned") reside at ____________________________________ in _____________________, ____. 1. Acknowledge that there is an inherent danger involved in being transported to and from various classes and in working with glass at various temperatures, and that attending Hot Glass Horizons 2007 involves risks that may cause personal injury or death. 2. Voluntarily assume the risk and danger of injury or death inherent in the use of the equipment and tools provided by Hot Glass Horizons 2007 and its instructors. 3. Release, discharge and promise not to sue Hot Glass Horizons 2007, doing business under its own name or any other name and/or any of its owners, officers, employees, instructors and agents (hereinafter the "Releasees") for any loss, liability, damage or cost whatsoever arising out of or related to any loss, liability, damage or injury (including death) to my person or property. 4. Release the Releasees from any claim that such releasees are or may be negligent in connection with my educational experience, including but not limited to instruction on glass working techniques, transportation to and from seminar activities, maintenance or care of glass working tools and equipment. 5. Indemnify, and save and hold harmless the releasees from any loss, liability, damage, injury or cost that may arise out of or in any way connected with my use of glass and any of the tools and equipment provided herewith or any acts or omission of releasees, or other employees or agents. 6. Agree to abide by and follow any instructions given or rules established by Hot Glass Horizons 2007 or any of its instructors, agents or employees with regard to my safe operation and use of glass and glass working tools and equipment.. 7. The Undersigned expressly agrees that the foregoing release and waiver of liability, assumption of risk, and indemnity agreement is governed by the state of Oregon and is intended to be as broad and inclusive as is permitted by Oregon law, and that in the event any portion of this Agreement is determined to be invalid, illegal or unenforceable, the validity, legality and enforceability of the balance of the agreement shall not be affected or impaired in any way and shall continue in full legal force and effect. 8. Acknowledge that this document is a contract and agree that if a lawsuit is filed against Hot Glass Horizons 2007 or its owners, agents, employees or instructors for any injury or damage in breach of this contract, the Undersigned will pay all attorney's fees and costs incurred by Hot Glass Horizons 2007 in defending such action. I Have Read This Document. I Understand It Is A Promise Not To Sue and A Release And Indemnity For All Claims. ___________________________________ Signature _________________ Date |