The Wild Source - Traveler Information Form

Instructions

  • Please fill out one form for each traveler
  • Email address should be unique to each traveler (leave blank if they have no email address)
  • All passport and medical information is encrypted.
  • Notes: Please add any special occasions and/or requests
  • If you need to update your information, you can resubmit this form at anytime.

You can find this on your trip proposal in the payment section

Must match passport

Must match passport

Must match passport

This field must be unique for each traveler

MM/DD/YYYY

MM/DD/YYYY

MM/DD/YYYY


e.g. food allergies, vegetarian, gluten free, etc.

e.g., 1 Bed: King/Queen; 2 Beds: Twin; etc.

Who are you sharing with?

LIABILITY RELEASE & ASSUMPTION OF RISK AGREEMENT

Please read carefully before signing.  A separate form must be signed for each traveler.

VOLUNTARY PARTICIPATION AND ASSUMPTION OF RISK

I acknowledge that I have voluntarily chosen to participate in a trip arranged by The WildSource, LLC. In so doing, I acknowledge that I may be subjecting myself to dangers and hazards, which could result in illness, injury, or death. I also acknowledge that there are inherent risks and dangers, which may arise at any time during the trip. I am specifically familiar with and accept the risks of the dangers and hazards for this type of adventure travel. I am aware that medical services or facilities may not be available while I am participating in the trip. In order to partake of the enjoyment and excitement of this adventure travel trip I am willing to accept the risks and uncertainty involved as being an integral part of the adventure. I agree to assume all risks of illness, injury or death.

RELEASE AND COVENANT NOT TO SUE

I understand that The Wild Source, LLC will contract with independent contractors to provide services on this trip, including transportation, travel services, and guide services. I understand and acknowledge that The Wild Source, LLC has no control over and assumes no responsibility for the actions of any independent contractors, and that no independent contractor has authority to make commitments for or on behalf of The Wild Source, LLC. In the event of a failure to deliver by a contracted supplier, The Wild Source, LLC, has a duty to find the best suitable alternative service as a replacement.
As partial consideration for my being permitted to participate in the trip and for The WildSource, LLC’s undertakings, I agree that neither I, nor any of my heirs, personal or legal representatives, or family members will bring suit against The Wild Source, LLC, a Colorado registered limited liability company doing business as The Wild Source, as a result of any acts or omissions by The Wild Source, LLC or its independent contractors. I hereby release, indemnify, and covenant not to sue The Wild Source, LLC, or its officers, directors, shareholders, agents, employees for any and all claims of whatever kind arising from my participation in the trip, including, but not limited to, personal injury, illness, death, damage, or monetary losses.

ARBITRATION

Any controversy or claim arising out of or relating to this agreement or the performance thereunder, including without limitation any claim related to illness, injury, or death, shall be settled by binding arbitration in the state of Colorado, in accordance with the Commercial Arbitration Rules of the American Arbitration Association then existing, and judgment on the arbitration award may be entered in any court having jurisdiction over the subject matter of the controversy. This agreement to arbitrate does not waive or modify the liability release contained in the foregoing paragraphs.

KNOWING AND VOLUNTARY EXECUTION

I have carefully read The Wild Source, LLC reservation information, I have familiarized myself with all the information provided to me about this trip, and I agree to all stated conditions set forth in the reservation information, specifically including the section outlining the terms and conditions of this agreement. I understand that it is a release of liability and a contract between myself and The Wild Source, LLC and/or its contracted tour operators and affiliated organizations, and I sign this agreement of my own free will. This agreement is binding on my heirs, legal representatives and assigns.

INTEGRATION AND SEVERABILITY

Subject to the obligations and duties set forth herein, this Liability Release and Covenant -Not to Sue, The Wild Source Terms & Conditions, and Travel Insurance Acceptance Form, all of which are incorporated herein by this reference, express the full and complete agreement and contract of the parties here to. In the event that any term or terms of these documents are declared invalid by an arbitrator or court of law, such declaration shall not affect the remainder of the terms of the agreement, which shall be valid and enforceable.

ELECTRONIC SIGNATURES

This Agreement may be executed and delivered by electronic means and upon such delivery the electronic signature will be deemed to have the same effect as if the original signature had been delivered to The Wild Source, LLC.
I understand that typing my name below constitutes a legal signature confirming that I acknowledge and agree to the above Liability Release & Assumption of Risk Agreement.

OR

Signature of parent or guardian of participant (if applicant is under 18 years of age).

If I am signing on behalf of a minor I agree to RELEASE, HOLD HARMLESS AND IDEMNIFY the entities named above for any claims of the minor.

(Sign below: [Guardian Name ] on behalf of [Minor's Name]).


THE WILD SOURCE TERMS AND CONDITIONS 

1) RESERVATIONS AND PAYMENTS

A) Reservations should be made by contacting The Wild Source, hereinafter referred to as TWS, at the address indicated below.

B) Safaris are booked and confirmed only on receipt of a 30% advance payment of the basic safari rate. In some cases, such as gorilla trekking permits there may be additional costs due at the time of deposit beyond 30%. TWS will notify you of the deposit amount due. This advance payment is due within ten (10) days of making the reservation. There shall be no binding contract until the advance payment has been received by TWS. Failure to remit your advance payment on time will result in an automatic change of status of any confirmed space to a provisional basis and the possible inability to reinstate your reservation. When TWS receives your advance payment, a booking reference number will be assigned and noted on your original invoice. This number shall be deemed to constitute acceptance and confirmation of your booking. Your cancelled check and or wire transfer authority will act as your receipt.

i) If TWS is NOT making your complete travel arrangements for you, it will be necessary to furnish us with a copy of the confirmation of your transportation arrangements. TWS cannot be held liable for any penalties or losses incurred as a result of voluntary or involuntary changes to transportation schedules.

ii) Please make all payments by check payable (and send) to:

The Wild Source 801 14th Street Golden, CO 80401

iii) Alternatively, payments can be made by credit card or wire transfers by prior arrangement with TWS. Such alternate payments may incur a surcharge to be quoted by TWS.

C) The balance is due no later than ninety (90) days prior to commencement of your safari. If the balance has not been received by that date, TWS shall be entitled in its discretion to treat your reservation as canceled, and consequently to forfeit such part of the advance payment as determined solely by TWS. Late payments will be subject to a 5% surcharge on the balance.

D) Any reservation made within ninety (90) days of commencement of a safari may be accepted provided space is available, payment in full is received, and provided that documents can be delivered prior to departure.

E) TWS will not provide tickets, coupons, vouchers or documents until full payment has been received by TWS.

F) TWS will not accept responsibility for wire transfer and / or overnight mail charges.

G) No client will be permitted into the field without payment in full being received by TWS.

H) Special airfares are capacity controlled and often sold out months in advance. In addition, many accommodations offered by TWS have a limited capacity. It is essential to make reservations well in advance to insure your preferred arrangements.

2) CANCELLATION AND REFUNDS

A) Any cancellation of a booking must be in writing and shall only be effective upon its acknowledged receipt by TWS. At the time of cancellations, a full refund or credit will be made, less the following charges:
B) Up to 91 days before departure: 30% of the package price.
C) Less than 90 days before departure: 100% of the package price.

B) If you are a "no show", TWS shall be entitled to treat your reservation as canceled without having given TWS any notice, and the provisions of Paragraph 2(A) shall apply.

C) Any request to amend or change a booking once it has been confirmed may be accommodated subject to space availability. If TWS is able to assist, an administrative fee of $100 per change will be assessed at TWS’s discretion. These fees will be added to your final invoice.

D) No refunds are given (1) for lost travel time or substitution of facilities, (2) for itineraries amended after departure, (3) for circumstances arising beyond the control of TWS, necessitating alternative arrangements being made to ensure the safety and / or further participation and enjoyment of your safari, (4) if you do not appear for any accommodation, service, sightseeing or trip segment without notifying TWS, or (5) if you leave your safari after it has begun, or miss any scheduled sightseeing, activities, meals or accommodations.

3) FOR YOUR INFORMATION

A) TWS acts as booking agent for hotels, airlines, air charters, bus companies, ground transportation, boat purveyors or owners, and other independent contractors providing accommodations, transportation and/or other services abroad. Each of these companies is an independent corporation with its own management and is not subject to the control of TWS, including, but not limited to, various overseas ground operators.

B) All bookings like those described above are accepted by TWS as agent for independent overseas ground operators. The transportation, accommodations and other services provided by ground operators are offered subject to the terms and conditions contained in the tickets, exchange orders or vouchers issued by them or their suppliers. Because TWS does not have the right to control the operations of the independent operators and their suppliers, TWS cannot be held liable for any personal injury or property damage which may arise out of these services. TWS reserves the right to cancel any itinerary or any part of it, to make such alterations in the itinerary as it deems necessary or desirable, to refuse to accept or to retain as a member of any safari any person at any time, and to pass on to safari members any expenditure incurred by delays or events beyond its control. In case of any appreciable variation in cost, TWS reserves the right to adjust its rates.

4) RISKS

A) TWS draws your attention to the fact that there are certain inherent risks involved in participating in the type of trips sold by TWS. You will be required to sign a Release to acknowledge this warning and also to release and hold harmless TWS from any damages that may result. By signing this agreement, you also agree to assume all risks related to COVID-19.

B) It is your sole responsibility to take all appropriate medical advice prior to departure as to whether or not you are fit enough to undertake the trip booked. TWS shall not be liable for any illness, injury or death sustained on a safari sold by TWS which is not due to the negligence of TWS, its officers, employees, authorized representatives or agents whomsoever.

5) FORCE MAJEURE

A) "Force Majeure" shall mean that TWS will not be liable for any alleged damages because of any circumstances including, but without limitation, acts of God, explosion, flood, tempest, fire or accident, war or threat of war, sabotage, insurrection, civil disturbance, or requisition, sickness, quarantine, government intervention, weather conditions or other untoward occurrences.

B) If TWS is affected by Force Majeure it shall forthwith notify you of the nature and extent thereof.

C) TWS shall not be deemed to be in breach of these terms and conditions or otherwise be liable to you, by reason of delay in performance, or by non-performance, of any of its obligations hereunder to the extent that any such delay or non-performance is due to any Force Majeure.

D) If TWS is affected by Force Majeure it shall be entitled to, and may in its sole and absolute discretion, vary or cancel any itinerary or arrangement in relation to the trip. Payment of any refund by TWS to you as a result of the non-performance of any of the obligations of TWS hereunder shall remain in its sole and absolute discretion, although TWS shall use its reasonable endeavors to reimburse you where possible. However, TWS shall be entitled to deduct from any refund recoverable the reasonable actual and potential costs to TWS of the Force Majeure.

E) Regarding civil unrest, once TWS has investigated the prevailing situation as it deems fit, it shall remain in the sole discretion of TWS whether to proceed with the trip. You may in such circumstances cancel the trip. However, if, after having made all reasonable and proper inquiries, TWS is of the opinion that the trip may proceed, no refund will be payable to you and the provisions of Paragraph 2 shall apply.

6) INSURANCE

TWS requires that you obtain comprehensive travel insurance including medical coverage and emergency evacuation coverage.

7) SURCHARGES AND EXCHANGE RATES

A) Although TWS hopes that it would not need to levy surcharges it reserves the right to do so on the invoice amount, if this becomes necessary. TWS will endeavor to notify you in writing as soon as it is ware of any likely surcharge, and you must pay the amount of such surcharge no later then ten (10) days after written notification has been 8 received (depending on the circumstances). If the surcharge is not paid within such time, TWS may construe such non-payment as an act of cancellation on your part and the provisions of Paragraph 2 shall apply.

B) Rates used in the safaris are based on tariffs and exchange rates valid at the time of printing and advertising safaris. Should a rate vary against the U. S. Dollar by more than 3%, TWS reserves the right to recalculate the safari cost and apply the differential as a surcharge. Any refund made by TWS shall be in its absolute and sole discretion.

8) TERMS AND CONDITIONS

These terms and conditions govern the relationship between TWS and you, to the total exclusion of any other terms and conditions. No alterations to the terms and conditions may be made by any unauthorized employee of TWS, authorized representatives or agents, unless in writing by an authorized employee of TWS. All decisions and matters subject to the discretion of TWS shall be made by an authorized officer or employee of TWS.

9) CARRIAGE BY LAND, SEA AND AIR

A) Carriage by Land, Sea and Air is subject to the terms and conditions of the carrier with whom you travel and to international conventions – some which may limit liability. Land, Sea and Air travel are also subject to operational decisions of carriers and sea ports which may result in cancellations, delays or diversions, over which TWS has no control and for which TWS accepts no liability whatsoever.

B) The passenger contract in use by the airline carriers concerned, when issued, shall constitute the sole contract between the transportation companies and the purchaser of these programs and/or the passengers.

10) BAGGAGE

Temporary or permanent loss of baggage is the responsibility of you or the carrier. It is recommended that you obtain travel insurance for protection.

• Please note that when traveling by light aircraft during your safari, space is limited, and luggage is limited to a weight restriction (typically 33 lbs in most areas and 44 lbs in Botswana) per passenger, and ONLY soft luggage or duffel bags are allowed. No hard suitcases are allowed, and NO EXCEPTIONS will be made.

11) TRAVEL DOCUMENTS AND VACCINATIONS

It is your responsibility to ensure that passports, visas, travel permits, health certificates, inoculations, international driving license, or other documentation required for the trip are obtained and are in order. It is your responsibility to meet any additional costs incurred by yourself or by TWS on your behalf as a result of any failure by you to comply with such requirements. Anti-malaria precautions should be commenced according your doctor’s instructions. Please consult your physician for more details. Safari clients should bring their own insect repellant.

12) SPECIAL REQUESTS

You must advise TWS in writing of any special requests, i.e. diet, facility or physical handicap, when you submit your reservation request to TWS, which will be met if possible.

13) INFORMATION IN BROCHURES / ELECTRONIC ADVERTISEMENTS

All information given in any brochure or otherwise advertised, (including electronic advertisements on the Internet) is, to the best of TWS’s knowledge, correct, but TWS reserves the right to change same. The photographs reproduced and information provided depict typical scenes experienced and details on each destination; but the subject matter may not necessarily be seen or experienced while visiting that destination.

14) PHOTOGRAPHY

TWS reserves the right without further notice to make use of any photography or film taken on this safari by any staff member, safari guide or operator for general purposes without payment or permission.

15) DISPUTES

If you have any cause for complaint while on safari, you must immediately bring it to the attention of the local representative of TWS or agent, who will attempt to resolve the situation.

16) CONSENT

The payment of the advance payment OR any partial payment for a reservation on a safari constitutes consent to all provisions of the conditions and general information contained in any brochure (electronic or otherwise), invoice and travel documents. The terms under which you agree to take these safaris cannot be changed or amended, except in writing, signed by an authorized officer or employee of TWS.

17) CONDITION OF BOOKING

You shall comply with instructions of any representative of TWS, safari guide or local ground operator at all times. No client shall be accepted or be permitted to continue on a safari while their status or mental or physical condition is, in the opinion of any representative of TWS, safari guide or local ground operator, such as to render them incapable of caring for themselves or make themselves objectionable to other safari clients or become a hazard to themselves or other safari clients and TWS will not be responsible for expenses by such persons precluded from completing the safari for this reason. Please remember, when you book travel related services with TWS, you are entering into a binding agreement that assumes all terms and conditions are fully understood as stated in this document.

I HAVE READ, UNDERSTAND AND AGREE TO ALL OF THE TERMS & CONDITIONS

Please type your name to agree to the terms and conditions.