Print & Mail completed form to:
Regis Martin: 319 Silvio Lane, Novato, CA 94947

REGIS MARTIN
Purveyors of Distinguished Northern California Excursions
TOUR ENROLLMENT FORM

TOUR DEPARTURE DATE:

Participant Information:
FIRST NAME:

LAST NAME:

HOME ADDRESS:
(Street, City, State & Zip)

TELEPHONE:

SPECIAL ASSISTANCE:
(Walker or Bedding)

Guest or Spouse Information:
FIRST NAME:

LAST NAME:

HOME ADDRESS:
(Street, City, State & Zip)

TELEPHONE:

SPECIAL ASSISTANCE:
(Walker or Bedding)

Accommodation Preferences:
Preferred Bedding:
(2 doubles or 1 queen)

Traveling with other couples?
(Names & Home City)

Preferred airline seating:

Frequent Flyer Number:

I have read and accept the Regis Martin terms, conditions and cancellation policy.

_________________________ __________________________
Signature of Participant Signature of Guest/Spouse Participant

Terms, Conditions and Cancellation Policy

Terms & Conditions:
1) I have read and understand the Regis Martin itinerary and agree to participate with the other tour members with the set schedule and calendar of touring. Once the tour commences and if I choose to leave the group I will be held responsible for the all charges that I will incur while traveling on my own. If I elect to return early to my "departure" city, I will be responsible for all airfare increases and change fees. I further understand that Regis Martin will not be responsible for reimbursing me for tour package if I should choose not to complete the tour.
2) I am considered in "good health" and can participate in walking to the various landmarks, wineries and attractions. If I am in need of assistance, I agree to advise Regis Martin in the "Tour Enrollment Form" and will provide my own aids such as walker or cane. I will submit in advance the medical advisory form and list medications, medical providers contact information, and relative information to contact in case of an emergency.
3) I will not hold Regis Martin liable for any personal injury, death, property damage or other loss, accident, delay, inconvenience or irregularity which may be brought upon by 1) any wrongful, negligent, willful or unauthorized acts or omission on the party of any suppliers or other employees or agents, 2) any defect in or failure of any vehicle, equipment, or instrument owed, operated or otherwise used by any of these suppliers or 3) any wrongful, willful or negligent act or omission on the party of any other party, supplier, agent or other employee not under the supervision or control of Regis Martin. Additionally, responsibility is not accepted by Regis Martin for losses or expenses due to sickness, lack of appropriate services and accommodations, medical facilities or practitioners. I will further not hold Regis Martin responsible for weather conditions, strikes, theft or other criminal acts, war, terrorism, computer issues and other such causes.
4) Regis Martin reserves the right to withdraw or remove any tour from its tour schedule prior to departure. Regis Martin also reserves the right for refusal of service to tour participants prior to tour departure and/or during tour if the participant's conduct inhibits the safety, welfare, and health of the other tour participants or Regis Martin staff to a risk of physical harm, the tour guide will consult with the Regis Martin home office prior to taking steps to having the participant removed the group. If a participant is removed from the group, he or she will be responsible for all costs incurred for their duration of their stay and all expenses incurred for changed airfare to their departure city.
5) Baggage and personal effects are in the charge of the participant at all times. Regis Martin will not be responsible for lost or damaged personal property.
6) I give my permission for my photo to appear in potential upcoming advertising or promotions.

I have read and accept the Regis Martin terms, conditions and cancellation policy.

_________________________ __________________________
Signature of Participant Signature of Guest/Spouse Participant

Cancellation Policy: