PVS STEAMBOAT SPRINGS TRIP, FEBRUARY 17 - 23, 2011

APPLICATION, and RELEASE, ASSUMPTION OF RISK, AND

WAIVER OF LIABILITY AGREEMENT

(1) I acknowledge that there are inherent risks in the sport of skiing and other sports or activities in which I might participate during this trip, and in the process of traveling. There may be bodily injury, illness, accident, death, property loss or damage, and unanticipated additional costs or other economic losses. I fully and willingly accept the responsibility and liability for all such risks, dangers, costs, and losses.

(2) I agree not to sue or hold responsible the trip leaders, Potomac Valley Skiers, Inc. (hereafter PVS), its officers and members of the Executive Committee, or its members for: (1) any accident, personal injury, illness, or death occurring to me or to any other trip participant, arising directly or indirectly from this trip; (2) any loss of deposit or payment, any other property or economic loss, or unanticipated additional costs, delay, or change of itinerary arising out of any action or inaction of any hotel, airline, tour operator, land transportation operator, or other entity or person providing services on this trip; and (3) any trip cancellation, delay, early termination or extension due to acts of God, forces of nature, or other force majeure events or situations. I willingly and with full knowledge assume these risks.

(3) I understand and agree that the trip leaders, and the tour operators or agents with whom the trip leaders have contracted, have the right to substitute accommodations of similar or better quality, to change transportation arrangements and providers, and to modify other services. In the event of such changes, no refund or credit will be provided if the accommodations, transportation, or services are of comparable or better quality and cover the same approximate time period.

(4) I agree that I am not entitled to a credit or refund for any included trip service that is not used by me.

I have read and I fully understand this “Release, Assumption of Risk, and Waiver of Liability Agreement,” the trip description, and the trip application, and I agree to all of the specified terms and conditions.

PVS Steamboat Springs Ski Trip, February 17 - 23, 2011

Printed Name of 1^st Participant: _________________________________­­­­­­­­­­­­_ [ ] 65 or older

Signature of 1^st Participant:____________________________________Date___________

Printed Name of 2^nd Participant: ___________________________________ [ ] 65 or older

Signature of 2^nd Participant:____________________________________Date___________

Address: _____________________________________________________________________________________

Home Phone: _______________________________ Other Phone:______________________________________

Email Address: ________________________________________________________________________________

Roommate (if not listed above) ____________________________

[ ] Five-day lift ticket [ ] Four-day lift ticket [ ] Non-skier [ ] Not using group airfare

[ ] Deposit of $250 per person enclosed