The Following Form is For: 10-22,2019-Duels, Dungeons, and Pirates
Date: Tuesday, Oct 22,2019
1. First Name:
1. Last Name:
2. First Name:
2. Last Name:
Non-Spouse Roommate [Signing Up
If Overnight, I Will Room
Organization Name [If Applicable]:
Home Phone Number:
Work Phone Number:
Send Trip Detail 10 Days
Before Departure, By Email... By Regular Mail...
I am Sending a Check for
the Following Amount...
Special Message / Dietary
Following is our disclaimer.
By sending in the form, you will agree to the following: I (we)
waive any claim against tour coordinators, Weekend Get-Aways on
a Tank of Gas, LLC or Scottie Davis for any damage to or loss of
property or injury to or death of persons due to any act of negligence
by any bus, hotel, or other persons rendering any of the services
and accommodations on this trip. The tour coordinators, Weekend
Get-Aways on a Tank of Gas, LLC and Scottie Davis shall not be responsible
for any delays, substitution of equipment or itinerary or any act
of omission whatsoever by the carrier, its agents, servants, and
employees. Participants and travelers hereby waive any claim(s)
arising there from. The receipt of full payment by any participant
indicates acceptance of these terms and conditions. Full payment
is needed to reserve space on a trip. No refunds will be given after
the deadline date unless you find someone to take your place. In
the event the trip is cancelled, all monies paid by participants
will be refunded immediately.