Travel liability waiver

KOKOMERE ADVENTURE SAFARIS

ASSUMPTION OF RISK, RELEASE OF LIABILITY & EMERGENCY INFORMATION

Participant Full Legal Name: _______________________________________________

Date of Birth: __________________________

Home Address: ____________________________________________________________

City/State/Province: ______________________________ Postal Code: __________

Country: ______________________________

Phone: ______________________________ Email: ____________________________

EMERGENCY / HOME CONTACT INFORMATION

Emergency Contact Name: __________________________________________________

Relationship to Participant: _______________________________________________

Primary Phone: ________________________ Alternate Phone: _________________

Email: ___________________________________________________________________

Home Contact Address: _____________________________________________________

TRAVEL & MEDICAL INSURANCE INFORMATION

Participants are strongly encouraged to maintain comprehensive travel insurance, including emergency medical treatment and emergency evacuation/repatriation coverage appropriate for travel in remote areas of Africa.

Insurance Provider: ______________________________________________________

Policy Number: ______________________________________________________

24-Hour Emergency Assistance Number: ______________________________________

Emergency Medical/Evacuation Provider, if different: _________________________

Policy Number: ______________________________________________________

ACKNOWLEDGMENT AND ASSUMPTION OF RISK

I understand that participation in a safari organized or coordinated by Kokomere Adventure Safaris (“Kokomere”) involves travel in remote wilderness areas and activities that may involve inherent and unavoidable risks.

These risks may include, but are not limited to:

Encounters with wild animals, including potentially dangerous animals;

Travel in open safari vehicles and four-wheel-drive vehicles over rough, uneven, flooded, sandy, or poorly maintained roads and tracks;

Walking in wilderness areas and entering or leaving safari vehicles;

Mokoro, boat, canoe, or other water-based activities;

Camping in unfenced wilderness areas where wildlife may move freely through or near camp;

Exposure to insects, reptiles, plants, extreme heat or cold, sun, dust, smoke, storms, flooding, fire, and other natural hazards;

Illness, food- or water-related illness, injury, allergic reactions, or other medical emergencies;

Limited or delayed access to medical care, emergency services, communications, transportation, and evacuation;

Vehicle accidents, mechanical breakdowns, road conditions, border delays, flight delays or cancellations, and other transportation risks;

Actions or omissions of independent guides, camps, lodges, transport companies, airlines, activity providers, government authorities, or other third-party service providers.

I understand that Botswana safaris may take place many hours from hospitals or advanced medical facilities and that emergency evacuation may be difficult, delayed, expensive, or impossible under certain circumstances.

I voluntarily choose to participate in the safari with knowledge of these risks and accept the inherent and reasonably foreseeable risks associated with wilderness travel and the activities in which I elect to participate.

WILDLIFE AND GUIDE INSTRUCTIONS

I understand that wild animals are unpredictable and that no guide, operator, or safari company can guarantee my safety around wildlife.

I agree to follow all reasonable safety instructions provided by guides, camp staff, activity operators, and Kokomere representatives. I understand that failure to follow safety instructions may place me and others at serious risk.

I will not leave a vehicle, tent, campsite, boat, mokoro, or other designated safe area contrary to the instructions of a guide or staff member.

HEALTH AND FITNESS

I understand that I am responsible for determining whether I am physically and medically capable of participating in the safari and any optional activities.

I agree to advise Kokomere or the appropriate guide/operator of any condition, allergy, mobility limitation, medication requirement, or other circumstance that may reasonably affect my safety or emergency treatment.

I am responsible for carrying sufficient quantities of my necessary medications and for obtaining appropriate medical advice regarding vaccinations, medications, disease prevention, and travel to Botswana or any other destination included in my itinerary.

EMERGENCY MEDICAL TREATMENT AND EVACUATION

If I become ill or injured and am unable to make decisions for myself, I authorize Kokomere, its representatives, guides, or third-party operators to seek emergency medical treatment and/or evacuation that they reasonably believe is necessary.

I understand that Kokomere cannot guarantee the availability, timing, method, or outcome of medical treatment or evacuation.

I accept financial responsibility for medical treatment, transportation, evacuation, repatriation, accommodation, or other emergency expenses not paid by my insurance.

TRAVEL INSURANCE

I understand that safari travel may involve substantial non-refundable expenses and circumstances beyond Kokomere's control.

I understand that comprehensive travel insurance is strongly recommended, including coverage appropriate to my circumstances for trip cancellation/interruption, emergency medical treatment, medical evacuation and repatriation, baggage, and travel delays.

If I choose to travel without adequate insurance, I accept the financial risks associated with that decision.

RELEASE AND LIMITATION OF LIABILITY

To the fullest extent permitted by applicable law, I release and hold harmless Kokomere Adventure Safaris, its owners, officers, employees, representatives, and agents from claims for personal injury, illness, death, property loss, or other damages arising from the inherent risks of safari and wilderness travel or from circumstances reasonably beyond Kokomere's control.

I understand that Kokomere may arrange services provided by independent third parties, including guides, safari operators, accommodation providers, airlines, transfer companies, boat or mokoro operators, and other activity providers. Such providers may operate under their own terms, conditions, and liability provisions.

Nothing in this agreement is intended to exclude or limit liability that cannot lawfully be excluded or limited under applicable law.

PERSONAL PROPERTY

I understand that I am responsible for my own luggage, cameras, phones, passports, money, jewelry, equipment, and other personal property. I accept the risk of loss, theft, or damage except to the extent responsibility cannot legally be excluded.

ITINERARY CHANGES

I understand that safari itineraries may need to change because of weather, flooding, road or wildlife conditions, government restrictions, border issues, mechanical problems, safety concerns, flight schedules, or other circumstances.

I acknowledge that reasonable changes may be made when necessary for safety or because of circumstances beyond Kokomere's reasonable control.

PARTICIPANT ACKNOWLEDGMENT

I confirm that:

I have read this document in its entirety.

I understand the nature and risks of the safari activities in which I intend to participate.

I have had an opportunity to ask questions before signing.

I voluntarily accept the inherent risks associated with safari and wilderness travel.

I understand that signing this document may affect my legal rights.

I am signing this document voluntarily and without coercion.

PARTICIPANT SIGNATURE

Participant Name (print): _________________________________________________

Signature: ________________________________________________________________

Date: ______________________________

IF PARTICIPANT IS UNDER 18

I am the parent or legal guardian of the participant named below. I have read and understand this agreement and consent to the minor's participation.

Minor Participant Name: ___________________________________________________

Parent/Legal Guardian Name: _______________________________________________

Parent/Legal Guardian Signature: ___________________________________________

Date: ______________________________

This waiver must be signed and returned the same day deposit/payment is made. If you are 

booking within 45 days of departure, signed waiver must be returned the same day 

booking and final payment are made. A SIGNED FORM IS REQUIRED FOR EACH ADULT 

PARTICIPANT IN ORDER TO TRAVEL.

THIS IS A RELEASE OF LIABILITY. This Waiver is entered into between the Participants on 

the reservation (“I”, “You”) and The Company from which you purchased your vacation 

tour or cruise (“The Company”). In all cases, the person signing this waiver warrants that 

he/she has consented to, accepted, and agreed to be bound by all clauses below.

ASSUMPTION OF RISK

1. I acknowledge that I am fully aware of and appreciate the real dangers and risks while 

on safari arising from the presence of wild and dangerous animals, including but not 

limited to:

a. mammals, reptiles, birds, and insects 

b. and the real risk of suffering bodily harm, injury, death and/or damage to 

or loss of property

that may arise as a result of an encounter with and/or the presence of such animals 

while on my trip. 

2. I acknowledge that my trip will include encounters with wild animals and I further 

understand and acknowledge that the behavior of wild animals cannot be predicted 

or controlled.

3. I am aware of the risks of safari travel that includes encounters with wild and 

dangerous animals, including risks associated with my safety. 

4. I am aware that medical facilities while traveling may not be of the quality of medical 

facilities I experience at home and access to evacuation and/or suitable medical 

supplies and support may not be as readily available as I am accustomed to.

5. I am aware that no one can guarantee my safety while traveling and I acknowledge I 

have been strongly advised to have comprehensive health and accident insurance 

(including “travel insurance”), which provides coverage for illnesses or injuries I 

sustain or experience while traveling including pandemic/epidemic/infectious disease 

coverage, cancellation / curtailment coverage, medical evacuation, repatriation of 

remains, and life insurance. 

6. I am voluntarily participating in this tour/cruise with knowledge of the inherent risks 

of travel and with travel that includes encounters with wild and dangerous animals, 

and I agree to assume all risks, including but not limited to those listed in this release 

of liability, whether those risks are known or unknown. I am aware that payment of 

deposit on the reservation indicates acknowledgement and acceptance of these risks.

7. I am voluntarily participating in this trip, and I have voluntarily purchased this trip 

from The Company with the full understanding of these risks. I hereby assume and 

agree to accept any and all risks to my safety and security during the course of my 

trip, and I hereby release The Company and the Releasees from any claims that may 

arise during the course of my participation in the trip.I understand I am legally bound by the payment 

arrangements and schedule found in the T&C section of this website.

This Waiver shall be binding on myself, my family, my heirs, and any attorney, agent, 

executor, trustee, representative or assignee. I hereby indemnify and hold harmless The 

Company and the Releasees for any Claims against The Company or the Releasees by any 

member of my family, my heirs or assigns, my estate, my employer or by any other 

person for whom or to whom I am or may be responsible, whether at law or otherwise. 

GUEST: PARENT (GUARDIAN) if Traveler is under 18:

Signature 

_________________________________

Please Print Name

_________________________________

Date of trip

_________________________________

Today's date

__________________________________

Contact name and number of family or friend

___________________________________________

r and phone number ________________________________________________________________________

Please mail this information to kokomere Adventure Safaris, 130 high Hill Lane, Washington Virginia 22747 or 

Email to: