Guest Details Trip Dates(Required) (Trip 523) Oct 07 2024 - Oct 14, 2024 (Trip 524) Oct 14 2024 - Oct 21, 2024 (Trip 525) Oct 21 2024 - Oct 28, 2024 (Trip 526) Oct 28 2024 - Nov 04, 2024 (Trip 527) Nov 04 2024 - Nov 11, 2024 (Trip 528) Nov 11 2024 - Nov 18, 2024 (Trip 529) Nov 18 2024 - Nov 25, 2024 (Trip 530) Nov 25 2024 - Dec 02, 2024 (Trip 531) Dec 02 2024 - Dec 09, 2024 (Trip 532) Dec 09 2024 - Dec 16, 2024 (Trip 533) Dec 16 2024 - Dec 23, 2024 (Trip 534) Dec 23 2024 - Dec 30, 2024 (Trip 535) Dec 30 2024 - Jan 06, 2025 (Trip 536) Jan 06 2025 - Jan 13, 2025 (Trip 537) Jan 13 2025 - Jan 20, 2025 (Trip 538) Jan 20 2025 - Jan 27, 2025 (Trip 539) Jan 27 2025 - Feb 03, 2025 (Trip 540) Feb 03 2025 - Feb 10, 2025 (Trip 541) Feb 10 2025 - Feb 17, 2025 (Trip 542) Feb 17 2025 - Feb 24, 2025 (Trip 543) Feb 24 2025 - Mar 03, 2025 (Trip 544) Mar 03 2025 - Mar 10, 2025 (Trip 545) Mar 10 2025 - Mar 17, 2025 (Trip 546) Mar 17 2025 - Mar 24, 2025 (Trip 547) Mar 24 2025 - Mar 31, 2025
Full Name(Required)
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Gender(Required) Male Female
Nationality(Required) Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Islands Colombia Comoros Congo, Democratic Republic of the Congo, Republic of the Cook Islands Costa Rica Croatia Cuba Curaçao Cyprus Czech Republic Côte d'Ivoire Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini (Swaziland) Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Réunion Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Islands Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu US Minor Outlying Islands Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Åland Islands
Domestic Flight Arrival for Start of Trip
Domestic Flight Departure at end of Trip Departure Time(Required)
Baggage Policy and Info If you will have additional baggage please send us an email with details as there is a possibility the airline will be unable to uplift bags without prior cargo reservations
Allergies and Dietary Requests
Emergency Contact Full Name(Required)
First & Last name
Medivac Insurance Information
Guest Contact Details T-Shirt Size(Required) S M L XL XXL
Board Short Size(Required) 29 30 31 32 33 34 36 38
Home Address(Required)
Agreement 1. ACTIVITIES COVERED
This Voluntary Agreement to Release Rights with respect to and Waive Liability against Indies Trader Beran Resorts Inc. (the “Agreement") is made in contemplation of any and all island, beach, ocean, fresh water, pool/spa and/or other physical activities pursued while at Beran Island or aboard the MV Indies Trader, MV Indies Surveyor, MV Windward, MV Trader TOO, MV Indies Trader lll including but not limited to, surfing, body surfing, swimming, diving, scuba diving, snorkelling, boating, riding wave runners or jet skis, beach combing, kite boarding, wind surfing, paddle boarding, stand-up paddle boarding, skim boarding, body boarding, fishing, airplane riding, weight lifting, exercising, hiking, wild life viewing or interaction, kayaking, canoeing, wake boarding, hydro foil boarding, sailing, rowing, jet boarding, and other physical activities both on and off shore (hereinafter the "Released Activities"). I further understand that from time to time, I may be offered the opportunity to participate in other activities not listed above. I understand and agree that such activities are also included within the meaning of the term Released Activities.
2. PARTIES BOUND BY THIS AGREEMENT
It is my understanding and intent that this Agreement shall be binding on myself and all other persons or entities who may initiate any suit, action, claim, demand, or other proceedings arising out of the Released Activities, including but not limited to my estate, executors, heirs, legal representatives, administrators, successors and assigns.
3. CONTINUING AGREEMENT
I agree and acknowledge that the terms and conditions of this Agreement shall continue in full force and effect now and in the future at all times during which I participate, either direct or indirectly in the Released Activities.
4. RELEASE OF CLAIMS
I waive and release Indies Trader Beran Resorts Inc, Indies Trader Marine Adventures as well as their officers, directors, agents, attorneys, representatives, servants, employees, and shareholders (hereinafter the "Released Parties") from any and all liability, claims, demands, actions, or causes of action arising out of any damages, loss, or injury to me, my children, dependents and/or wards as well as to my property while participating in the Released Activities and/or using any equipment provided by the Released Parties, whether such damages, loss, or injury results from the active, passive, or gross negligence of any person or entity, or from any other cause.
5. ASSUMPTION OF RISK
I know, understand, and acknowledge the scope, nature, and extent of the risks involved in the Released Activities and all other related activities contemplated by this Agreement. I acknowledge and understand that the released Activities, in particular engaging in water sports and other adventure sports and activities on or near the remote area of this trip, are inherently dangerous activities in which there is a risk of serious, permanent bodily injury or death and that no amount of care, caution, instruction, experience, or expertise can eliminate the dangers associated with the Released Activities. I further understand and acknowledge that the uniqueness of this trip and its remote location further increases the risks inherent in the Released Activities. I acknowledge that I have been advised to wear a helmet and to take all available precautions while engaging in the Released Activities. I understand and acknowledge that even if I am a strong swimmer, an experienced participant in the Released Activities, and do everything reasonably prudent to avoid injury, that serious permanent injury or death may still result from my participation in the Released Activities. I expressly, voluntarily, and irrevocably assume all risk of death, personal injury, and/or damage to my person or property sustained while participating in the Released Activities, whether or not such death, personal injury and/or damage is caused by the active, passive, or gross negligence of any person or entity, including the released Parties, or from any other cause, to the fullest extent allowed by law.
6. COVENANT NOT TO SUE
I agree, on behalf of myself, my estate, executors, heirs, legal representatives, administrators, successors and assigns, never to commence, or assist in the initiation or prosecution of, any lawsuit, claim, demand, action, proceeding, or cause of action, against the Released Parties related to the Released Activities or any other activities contemplated by this Agreement.
7. DEFENSE AND IDEMNITY
I hereby agree, on behalf of myself, my estate, executors, heirs, legal representatives, administrators, successors and assigns, to defend, indemnify, save, and hold harmless the Released Parties from any and all losses, claims, actions, demands, proceedings, or causes of action of any kind and character which may arise directly or indirectly out of the Released Activities.
8. LIMITATION OF WARRANTIES
All equipment provided by Released Parties has been previously used by other individuals engaging in the Released Activities. Released Parties do not expressly or impliedly warrant that any equipment sold, rented, or provided by the Released Parties is fit for a particular purpose or is of merchantable quality. I understand and agree that the implied warranties of merchantability and fitness for a particular purpose and all other warranties, express or implied, are excluded from any sale, rental, lease, loan or provision of equipment, whether for a fee or not, and that all such equipment is purchased, rented, or provided "As Is" and "Where is". I understand, acknowledge and agree to perform a thorough personal inspection of any and all such equipment prior to using the same, and I shall use my best judgment as to whether to, in fact, use said equipment.
9. INSURANCE
I understand and accept that the released Parties do not provide medical, disability, completed operations, product liability, life, personal, accident, general liability or any other insurance whatsoever that covers any accident, injury, casualty, loss and/or death which may arise from the Released Activities. As against the Released Parties, I hereby waive any and all claims, rights, or benefits I may have from any adjacent, accessory, component, or individual insurance policy pertaining to the Released Activities. I certify that I have adequate medical, dental, supplemental, long-term disability, special and/or life insurance(s) to cover any injury or damage I may suffer and/or cause while participating in the Released Activities and/or using the equipment or, if I do not have such insurance, I agree to bear the cost of such injury or damage myself. I affirm that considering my lifestyle and the manner in which I am supporting myself, I have made adequate future provisions for myself, my spouse, and/or my children, if any, and any other heirs, dependents, successors, and family so that in the event of my injury, incapacity, disability, or death, they will suffer no financial burden or impairment.
10. UNAVAILABILITY OF MEDICAL TREATMENT
I understand that this trip will be through a remote, undeveloped area. Further, I understand that the Released Parties do NOT provide medical services and that medical facilities do not exist nearby. If I am injured and require medical attention, I understand that I will have to be transported via air or vessel to receive medical services, and that the Released Parties do not provide such transportation. While staff and principles will endeavour to reasonably assist as they are able in any emergency situation, they may not be properly equipped to supply the type of transportation necessary and/or weather conditions may prevent or delay transport. I further understand that there are private companies available that do provide such transportation and that I will need to make prior arrangements, independent of the Released Parties, to obtain transportation. I understand and acknowledge that even with insurance, preparation and planning it may take 12 - 24 hours for me to reach a hospital and/or receive medical treatment, but possibly even longer depending on weather and/or ocean conditions.
I acknowledge that my failure to make my own direct and personal arrangements to secure, in advance of my arrival in The Republic Of The Marshall Islands, or other area visited during this trip any such private insurance that provides medical emergency air transportation may significantly increase or exacerbate any injuries that I may suffer while engaging in Released Activities. It is my responsibility to conduct my own personal due diligence on any private insurance and/or transportation companies, and on the decision whether or not to purchase insurance for emergency transportation and medical care with such companies and to select, in advance, a company that suits my individual needs and requirements.
Notwithstanding the foregoing, I hereby expressly consent to receive first aid, medical treatment and/or any other services rendered to me in the event an injury, accident, or illness (hereinafter "Emergency Medical Services") I incur during my direct or indirect involvement with the Released Activities and/or as a guest of Indies Trader Beran Resorts Inc, Indies Trader Marine Adventures and I hereby agree, on behalf of myself, my estate, executors, heirs, legal representative, administrators, successors and assigns, to hold harmless the Released Parties from any and all losses, claims, actions, demands, proceedings, or causes of action of any kind and character which may arise directly or indirectly out of Emergency Medical Services provided or sought.
Consent(Required) I have read and agree to the above sections.
11. STATEMENT OF PHYSICAL CONDITION
I recognize that the Released Activities are strenuous, athletic endeavour’s requiring me to be in no less than good physical condition, and that even if I am in good physical condition, I may suffer physical or mental injuries during my participation in the Released Activities. I hereby certify that I am not aware of and do not suffer from any physical or mental infirmities or chronic illness which may affect my ability to engage in any Released Activities, and that I am not under treatment for any physical and/or psychological conditions which will affect my ability to participate in the Released Activities. I hereby attest and verify that I am physically fit and that my physical condition has been verified by a licensed medical doctor. I further certify that I am willing to assume the risk of any medical or physical condition I may have, whether I am aware of said condition or not.
12. DRUG/ALCOHOL USE
The use of illegal drugs is strictly prohibited and may result in immediate removal from the vessel and/or the surrounding waters. The use of alcohol or any over the counter and/or prescription drugs which may have an intoxicating affect, or which may diminish one’s capacities is STRICTLY PROHIBITED prior to and while participating in any Released Activities.
13. ENFORCEMENT
I understand and agree that if any clause or provision of this Agreement is determined to be legally unenforceable, only said clause and/or provision shall be invalid and deemed deleted from this Agreement, however, the remainder of this Agreement shall continue to be binding and enforceable against me and all other parties or entities bound by this Agreement who may initiate any suit, action, claim, demand, cause of action or other proceeding arising out of my participation in the Released Activities and/or use of the equipment.
14. JURISDICTION, VENUE, TRIAL
I hereby agree that any and all claims, suits, disputes, demands, or actions of any kind whatsoever arising from or in connection with this Agreement and/or the Released Activities shall be commenced, filed, and litigated, if at all, before a court of proper jurisdiction in the location determined by Indies Trader.
15. ENTIRE AGREEMENT
I hereby acknowledge and understand that this written Agreement contains the complete and entire agreement between myself and the Released Parties, and that this Agreement supersedes in whole any oral or other written agreements between the parties. Further, I am not relying on any oral or written promises, terms, representations, assurance, or other material of any kind, including advertising material and brochures.
16. WAIVER OF LEGAL RIGHTS
I have read this Agreement and understand its terms and conditions. I understand that I am waiving important legal rights by executing this Agreement and that if I institute any suit, action, claim, demand, or other proceedings as a result of any injury, damage, or loss arising out of or in connection with this Agreement and/or the Released Activities, this Agreement can and will be used against me and any individuals or entities bound by this Agreement, and that releases and waivers of this type have been upheld by Courts of this jurisdiction in similar circumstances.
17. MODIFICATIONS OF THE AGREEMENT
I understand that this Agreement is a binding contract and that no oral representations or statements of any kind by any person can modify or amend the rights, duties, and obligations of the parties to this Agreement. I fully understand that any modification of this Agreement shall be enforceable only if it is in writing and separately signed by a duly authorized officer of Indies Trader.
18. ADVICE OF COUNSEL
I have been advised that I am free to seek independent advice or legal counsel of my own choosing before signing this Agreement.
19. FAILURE TO INITIAL
I hereby agree that should I execute this Agreement, but fail, for any reason, to initial any part of this Agreement where indicated, I shall be deemed to have initialled such portion of the Agreement.
I have read the above and agree to the terms. My signature and full name below will act as my digital signature.
Consent(Required) I have read the above and agree to the terms. My signature and full name below will act as my digital signature.
By my signature, I acknowledge and confirm that I have read, understand and agree to all booking conditions set forth.
I am aware that a “Beran Island” trip, in addition to usual and inherent risks, has certain additional risks and dangers which may include: physical exertion for which I may not be prepared: remoteness to normal medical services: weather extremes subject to sudden and unexpected change: and evacuation difficulties if I am disabled.
I accept all inherent risks of the proposed trip and possibility of personal injury, death, property damage or loss resulting there from.
In entering into the Agreement, I am not relying on any oral, written, or visual representations or statements by Beran Island Resorts Inc. & Indies Trader Marine Adventures, their agents or staff, or any other inducement or coercion to go on the trip, hence, only of my own free will.
Full Name
First
Last
Date Waiver Signed: 11/23/2024
Parent or Legal Guardian for Guests under 18 years (Must be completed for participants under the age of 18)
Participant is under 18 years old Yes - Participant is under 18 years old
I hereby represent that I am the parent, natural guardian, or legal guardian of the Participant and, acting in such capacity, I hereby consent to Participant's engagement in the Released Activities. In consideration for Participant being permitted to engage in the Released Activities, I hereby agree to defend, indemnify, and hold harmless the Released Parties from any and all losses, claims, actions, demands, proceedings, or causes of action which are brought by, or on behalf of, Participant. I hereby agree to defend, indemnify, and hold harmless the Released Parties from any losses, claims, actions, demands, proceedings, or causes of action which arise as a result of any defect in or lack of capacity to act as the parent, natural guardian of Participant. I further represent that I have read this entire Agreement and consent to its terms on behalf of Participant.
Signature of Parent or Guardian Full Name of Parent or Guardian
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