Release of Liability Please enable JavaScript in your browser to complete this form.Full Name *Country *FirstLastEmail *Phone Number *Date Birth: *Gender: *MaleFemaleI prefer not to say¿How did you find us? *GoogleFacebookFriendInformation KioskHotelLeaflet Tourist GuideOtherPerson who made the reservation: *IN CASE OF ACCIDENT, PLEASE INFORM THE FOLLOWING PERSON: *FirstLastI COMPROMISE TO: 1.- Follow the plan of activities and explained by the tour operator 2.- Do not touch, remove or extract any object or organism and do not damage or remove the environment 3.- Respect tour operator regulations 4.- Where appropriate, use my full equipment and wait for instructions from the tour guide, instructor or counselor. *I acceptBy checking the box above, you agree and confirm the information.PLEASE READ CAREFULLY AND PUT YOUR INITIALS AT THE END OF EACH PARAGRAPH CONSIDERING: THAT THE PARTICIPANT VOLUNTARILY WISHES TO CARRY OUT THE FOLLOWING ACTIVITY: HIKING, RAFTING, MOUNTAINEERING, CAMPING, EXCURSIONS, OUTDOOR ACTIVITIES. I, THE PARTICIPANT, DECLARE THE FOLLOWING: (put your initials at the end of each paragraph) 1. QUE LOCO TOURS HAS EXPLAINED, ILLUSTRATED AND/OR DEMONSTRATED TO MY SATISFACTION, THE NATURE, RISKS AND DANGERS OF THE ABOVE MENTIONED ACTIVITIES AND I ACCEPT THE RISKS. *I acceptBy checking the box above, you agree and confirm the information.2. I AM AWARE THAT IN THE ACTIVITY IN WHICH I WILL PARTICIPATE, THERE IS A POSSIBILITY OF SUFFERING INJURIES, LOSSES, TRAUMA OR DEATH *I acceptBy checking the box above, you agree and confirm the information.3. I DECLARE MY INTENTION TO PARTICIPATE IN THIS ACTIVITY FREELY AND AT MY OWN RISK AND SPECIFICALLY RELEASE QUE LOCO TOURS AND ALL ITS MEMBERS FROM ALL CIVIL LIABILITY FOR ANY LOSS OR DAMAGE, AS INDICATED IN POINT 2. *I acceptBy checking the box above, you agree and confirm the information.4. I DECLARE THAT I AM FREE FROM THE INFLUENCE OF ALCOHOL OR DRUGS AND THAT I WILL NOT USE ANY OF THESE BEFORE AND/OR DURING THE DEVELOPMENT OF THE ACTIVITY IN WHICH I WILL TAKE PART. *I acceptBy checking the box above, you agree and confirm the information.5. I AGREE TO FOLLOW THE INSTRUCTIONS GIVEN BY THE MEMBERS OF QUE LOCO TOURS, ITS GUIDES, INSTRUCTORS OR ANY OF THE EMPLOYEES. *I acceptBy checking the box above, you agree and confirm the information.6. I GRANTED THE RIGHT TO QUE LOCO TOURS TO USE PHOTOS OR VIDEOS IN WHICH I APPEAR, AND I AGREE THAT I HAVE READ THE PRIVACY NOTICE. *I acceptI do not acceptBy checking the box above, you agree and confirm the information.UNDER PROTEST TO TELL THE TRUTH, I STATE THAT I UNDERSTAND EACH PARAGRAPH OF THIS STATEMENT AND THAT ALL THE DATA PROVIDED ARE AUTHENTIC. I DECLARE UNDER PROTEST TO TELL THE TRUTH: BE HEALTHY AND NOT SUFFER FROM ANY ILLNESS OR CONDITION THAT PREVENTS ME FROM TAKING PART OF THE ACTIVITIES WITH OR WITHOUT APPLIANCES, SUCH AS: HEART PROBLEMS, LUNG PROBLEMS, RECENT SURGERY, EPILEPSY, DIABETES, INCLUDING PREGNANCY. *I acceptBy checking the box above, you agree and confirm the information.Allergies:Select oneYesNoBlood Type:¿HAVE YOU SUFFERED OR DO YOU SUFFER FROM OTHER MEDICAL PROBLEMS, OPERATIONS, INJURIES AND/OR SURGERY? WHICH? *ARE YOU CURRENTLY TAKING ANY MEDICATION? PLEASE MENTION IT AND THE REQUIRED DOSE:¿CAN THIS MEDICATION CAUSE ALTERATIONS OF CONSCIOUSNESS?Select oneYesNoDoes not applyNAME AND TELEPHONE OF THE DOCTOR WHO ATTENDS YOU:DESIGNATION OF BENEFICIARIES FOR ACCIDENTAL DEATH INSURANCE (1st person) *Full NamePercentage RelationshipDESIGNATION OF BENEFICIARIES FOR ACCIDENTAL DEATH INSURANCE (2do person) *Full NamePercentage RelationshipI ACKNOWLEDGE THAT I HAVE READ, UNDERSTOOD AND ACCEPTED THIS DOCUMENT AS WELL AS THAT I HAVE RECEIVED THE CORRESPONDING INDUCTION TALK *I accept the terms and conditionsBy checking the box above, you agree and confirm that all information is true and accurate. You state that you are telling the truth and acknowledge that you understand each paragraph of this statement and that all information provided is true.Submit
