Application for Grant Collier's Photography Workshop (Please print out this application and mail it to the address given below.) To reserve a spot in a workshop, please provide the following information (please print): Full Name: _______________________ Number of participants: _____ (Please note that any minors under the age of 18 must be accompanied by a parent or legal guardian.) Phone #: __________________ E-mail: ________________________ Street Address: _________________________ _________________________ City: ___________________ State: _______________ Zip: ___________ I am applying for the following workshop (check one) Hidden Moab - May 28-30, 2005 ($325) ____ Amount currently due is: $325 per person. Please write a check for the amount due to "Grant Collier" and mail it, along with your completed and signed application to the following address: Grant Collier 451 Wright St. #15 Lakewood, CO 80228 RELEASE I understand that there are inherent dangers in participating in this photography workshop, including, but not limited to, hiking, driving, and photographing outdoors, and my personal safety can not be guaranteed. I certify that I am in reasonably good physical condition and can complete hikes of 3-4 miles without significantly endangering my health. I hereby release and forever discharge Grant Collier and all other participants and assistants from any responsibility, personal liability, injury, death, claims, loss or damage arising out of or in conjunction with this photography workshop. I have read and agree to the terms and conditions outlined at http://www.gcollier.com/workshops/terms.htm Signatures of all applicants: Applicant #1: _______________________________   Date: ___________ Print Name: _______________________________ Applicant #2 (if applicable): _______________________________   Date: ___________ Print Name: _______________________________ Signature of parent or legal guardian (if under 18) __________________________ Applicant #3 (if applicable): _______________________________   Date: ___________ Print Name: _______________________________ Signature of parent or legal guardian (if under 18) __________________________ Applicant #4 (if applicable): _______________________________   Date: ___________ Print Name: _______________________________ Signature of parent or legal guardian (if under 18) __________________________ Applicant #5 (if applicable): _______________________________   Date: ___________ Print Name: _______________________________ Signature of parent or legal guardian (if under 18) __________________________ Applicant #6 (if applicable): _______________________________   Date: ___________ Print Name: _______________________________ Signature of parent or legal guardian (if under 18) __________________________ To print page, click on the 'File' menu and select print. When you are done printing, close this window to return to the previous page.