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To register, please print then fill out the information below and mail with a check payable to Richard Knepp Photo/Graphics for the full amount of the tuition. You may cancel your registration up 15 days prior to the start date, tuition will be refunded, less a $50 handling fee. Should a workshop be canceled for any reason by Richard Knepp Photo/Graphics, a full refund will be issued. A letter confirming your participation will follow shortly after receipt. Spouses or significant others are welcome to attend discussion groups, join us for meals, and may be present at our field locations without cameras, but must also sign the liability waiver below.
Each registrant must fill out a separate registration form.
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Workshop/Class Title:
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________________________________________
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Tuition:
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$____________
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Name:
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________________________________________
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Phone:
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________________________________________
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Address:
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________________________________________
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________________________________________
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City:
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________________________________________
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State:
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_________
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Zip Code:
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_________ Email address____________________________________
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(Tuition does not include transportation, meals or lodging unless specified in description.)
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(If more than one below is used, rank by frequency of use.)
Film: Color print ___ Slide/transparency ___ B&W ___
Digital Capture:<4 Megapixels___ 4-8 Megapixels___ >8 Megapixels ___
Camera(s) used: Point n’ shoot___ 35mmSLR ___ Medium format ___ Large format ___
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Liability Agreement, Waiver and Release/Parental consent
I/we have carefully read the description of the workshop(s)/activity(ies) listed above. I/we hereby waive, release and discharge any and all claims against Richard Knepp Photo/Graphics, its employees, instructors and/or volunteers for damages for personal injury, death or property I/we may have or which may accrue as a result of participation in said activities. This release is intended to discharge in advance Richard Knepp Photographics, its employees, instructors and /or volunteers from any and all liability arising out of my/our participation in said activities, even though that liability may arise out of the carelessness, negligence on the part of the persons or entities mentioned above. It is understood that theses activities involve an element of danger of accidents and risks and knowing those risks I/we assume those risks. It is further agreed that this waiver, release and assumption of risks is binding on my/our heirs and assigns. I/we agree to indemnify and to hold the above persons or entities free and harmless from any loss, liability, damage, cost or expense which they might incur as the result of my death or injury or property damage that I/we might sustain while participating in said activity. I/we understand that all tuitions and/or deposits become non-refundable one month before the event begins, unless otherwise noted.
Parental consent: I hereby consent that my son/daughter ___________________________ may participate in the above activities described in this brochure or prospectus, and I hereby execute the above Agreement, Waiver and Release on his/her behalf. I state that said minor is physically able to participate in said activities. I hereby agree to indemnify and hold the above mentioned persons and entities free and harmless from any loss, liability, damage, cost or expense which may incur as a result of the death or injury or property damage that said minor may sustain while participating in said activities.
I/WE HAVE CAREFULLY READ THIS AGREEMENT, WAIVER AND RELEASE AND FULLY UNDERSTAND ITS CONTENTS. I UNDERSTAND THAT THIS IS A RELEASE OF LIABILITY
AND A CONTRACT BETWEEN MYSELF/OURSELVES AND RICHARD KNEPP PHOTO/GRAPHICS AND I SIGN IT OF MY FREE WILL.
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____ Participant ____ Parent/Guardian
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____________________________
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_____________________________
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____________
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Printed Name
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Signature
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Date
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Spouse/Significant Other
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____________________________
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____________________________
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____________
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Printed Name
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Signature
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Date
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In the printed materials for the workshop, participant addresses and phone numbers are listed to allow for the future sharing of both knowledge and friendship. If you would prefer not to be included in such a list, please initial here: _____
Mail to:
Richard Knepp Photographics
171 Main Street #111
Los Altos CA 94022
510.583.0877
www.richardknepp.com
rick@richardknepp.com
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