| The Mamertion Foundation 9332 E. McGill Ct., Parker, CO 80134 2008 Excavations at Monte Palazzi |
| *** IMPORTANT INFORMATION *** * Application must be submitted by March 1st, 2008 * There is a $500.00 deposit required, which is due with application * Deposit is fully refundable until March 31st, 2008 * Deposits cannot be refunded after March 31st, 2008 but will be acknowledged as tax-deductible contribution * Refunds must be requested in writing prior to March 31st, 2008 |
| Name of participant: ______________________________________________________ Address: ________________________________________________________________ ________________________________________________________________ Telephone numbers: ________________________ (Day) ________________________ (Evening) E-mail address: _____________________________ Gender: MALE ( ) FEMALE ( ) Age: __________ Please specify any significant health problem, allergy (including food allergies), dietary need, or disability: ________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Person to be contacted in case of emergency: (Name) ____________________________________________ (Daytime Contact Number) ___________________________ (Evening Contact Number) ___________________________ (E-mail Address) ____________________________________ PARTICIPANTS MUST CARRY THEIR OWN HEALTH/DISABILITY INSURANCE! Please initial to verify that you have read and understand this statement: _________ Please check your session choice: 1st Session ( ) May 26-June 1 2nd Session ( ) June 2-June 8 3rd Session ( ) June 9-June 15 4th Session ( ) June 16-June 22 ROOM & BOARD and OTHER FEES - There is a tax-deductible weekly fee of $500.00, which may be increased by $50 if there is a drop in the dollar:euro exchange rate between March 1 and May 1. - A $500.00 deposit is required and is due with the application. Deposit is fully-refundable only until March 31, 2008. Thereafter, deposits cannot be refunded but will be acknowledged in writing as a tax-deductible contribution. Volunteer excavators will reside at the resort Villa Santa Maria, near Gioiosa Jonica. http://www.agriturismovillasantamaria.com e-mail: santamariaria@inwind.it - The daily cost of room and board at Villa Santa Maria will range between 40-50 euros per person. (Volunteers are expected to pay for their stay before leaving. The Villa does not accept credit card payments) Application Deadline: March 1st, 2008 I, (please print) ____________________________________ the undersigned, understand and accept the terms of this contract. I have read the description of this program and understand that the usual risks and dangers of travel apply. I hereby waive and release the program director, Professor Paolo Visona, The Mamertion Foundation, and all of its agents, volunteers, officers, and affiliates of any and all claims of damages and liability, whether known or unknown, arising from or in any way related to my participation in any of the events or activities associated with this program, including issues resulting from but not limited to; act of God, acts of nature, acts of terrorism, accidents, theft, damage to or loss of property, injury, death. Signature: ___________________________________________ Date: _______________ ___________________________________________ (please print name) PAYMENT ENCLOSED: Ist session: $__________________ 2nd session: $ _________________ 3rd session: $ _________________ 4th session: $ _________________ Total: $ ______________________ |