Pre-Workshop Questionnaire

Shetzers Photography Workshop Questionnaire

Participant Full Name Legal Name*

First NameLast Name

E-mail

example@example.com

Parent/Legal Guardian Full Name *

First NameLast Name

Parent/Legal Guardian Phone*

Area CodePhone Number

Workshop*

Grizzly Bears of Alaska Photo WorkshopBald Eagles of Alaska Photo WorkshopCosta Rica Highlands Photo WorkshopCosta Rica Tropical Lowlands Photo WorkshopGalápagos Photo TourPrivate Photo Workshop

Level of Photography experience*

Non-PhotographerNoviceAdvancedProfessional

What are your photography goals for time spent in the field photographing?*

What is your ideal image for this trip?

What are you main educational goals for our time in the workshops (ie. Image workup, in-flight techniques)

What camera gear will you be bringing (Brand and models please)?*

Medical Questionaire

Do you have any known allergies (ex.: Insect bites or sting, medications, food) or health conditions we should be aware of?*

Any mobility issue that would impact your ability to walk for short distances with your photography gear?*

Do you have any specified diet needs? (ex.: Vegetarian, do not eat certain kinds of meal/ fruits, and do not drink certain kinds of drinks) Please let us know if we need to make specific arrangements for you.

Emergency Contact

Full Name*

First NameLast Name

Relationship*

E-mail*

Phone Number*

If International trip, please provide the passport information below and email us a copy of the picture page in your passport to info@shetzers.com

Passport Nationality

Passport Number

Parent/Legal Guardian Permission and Assumption of Liability

As Parent/Legal Guardian of a minor child (participant), I hereby grant my permission for the above
named minor child to participate in the Shetzers Photography workshop.

I authorize qualified emergency medical personnel,including a physician and staff, to examine the above named minor child, in the event of injury, and to administer emergency care and to arrange for any consultation by a specialist, including a surgeon as deemed prudent for proper care of any injury. Every effort will be made to contact the Parent/Legal Guardian prior to any treatment.

I acknowledge, agree and understand that said participation involves risks and inherent dangers that may cause bodily injury or death, and/or property damage. On behalf of myself and the minor child above, the child’s estate and personal representative thereof, I agree to release and forever discharge Shetzers Photography.

Guardian Permission*

I agree to the Parent/Legal Guardian Permission and Assumption of Liability

Terms and Conditions*

International Information