Waiver, Release and Indemnification

I certify that my family understands the risks of the North Pole expedition and the legal consequences of this document. I am fully capable of participating in the expedition. I state that I have read the above statement on some of the possible risks and I voluntarily accept them. Therefore, I assume all risks inherent in participating in this activity, including but not limited to those listed above, for myself and my family, for bodily injury, death and loss of personal property and any expenses as a result of my negligence, negligence of my family, negligence of another participant or the negligence of VICAAR. I also understand that VICAAR reserves the right to refuse continued participation in the expedition to any person it judges to be incapable of meeting the requirements of participation. I am in good physical condition and able to undertake this expedition. I agree to indemnify and hold harmless VICAAR from all claims, damages, losses, injuries and expenses arising out of or resulting from my participation in these activities. This indemnification extends to the members of my family. In consideration of my being able to participate in the activity I agree to indemnify and hold harmless VICAAR for any costs associated with my death or with any injury I may receive, or transportation not covered in the itinerary due to my death or injury or early departure from the expedition. I agree that the cost of any search and rescue undertaken on my behalf will be my responsibility, including that undertaken by VICAAR, other expeditions, any government or other entity. I further agree to release VICAAR for any and all claims, causes of action or damages, or remedies in equity of whatever kind, including those alleging the negligence of VICAAR, other participants, my family, against VICAAR arising out of participation in this expedition. I understand that during the Expedition, certain events may occur which may necessitate certain additional costs not contemplated at this time, including but not limited to the cost of evacuation during any part of the Expedition, medical treatment, body recovery and/or repatriation, and other related matters. I agree that those additional costs are not the responsibility of VICAAR and that I am responsible for payment of those costs. I agree to pay for all costs of rescue and/or medical services as may be incurred on my behalf. I acknowledge that I am advised to buy my own personal life, medical, accident, travel, baggage, cancellation, rescue, and other insurance that may pertain to this trip. I understand that VICAAR provides me with no such insurance coverage. I hereby give permission for transportation to any medical facility or hospital and I authorize for any qualified guide or medical personnel to render necessary emergency medical care for myself. I hereby authorize the release of any medical information in the possession of VICAAR to any medical facility, hospital, ambulance, first aid provider, first aid service, doctor, nurse or other such person rendering care on my behalf. I hereby waive any action or claim against VICAAR or any health care provider, hospital, doctor, nurse or first aid provider for the release of this medical information. A copy of this release can be used as if it was an original. The terms of this agreement shall continue and be in effect after the expedition has ended. I acknowledge that team or group equipment is the property of VICAAR. I agree to pay VICAAR for any satellite communication charges that I incur while participating in the Expedition. I authorize and release to VICAAR the use of my image in any photograph or video recording for any purpose of VICAAR. I have adequate health, disability, and life insurance for my family and myself.

Signing this document I acknowledge I have read the VICAAR General Terms and Conditions and I understand and agree to the provisions contained therein.

Participant print full name:_________________________________________

Participant's Signature:__________________________ Date _____________