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␣<br />

E C O M A N T R A E C O - C A M P A P P L I C A T I O N F O R M<br />

Please read this form carefully before complet<strong>in</strong>g it <strong>in</strong> BLOCK CAPITALS and mail completed form with demand draft payable to<br />

“ECOMANTRA NATURE AWARENESS & TRAVEL” at:<br />

Adm<strong>in</strong>istration Office: A-18, 4 Th Floor, Girdhar Nagar, R.B Kadam Lane, LBS Marg, Ghatkopar (West), Mumbai 400086. INDIA.<br />

TEL.: (9122) 65248646, : www.ecomantra.org / www.ecomantra.com : <strong>in</strong>fo@ecomantra.org, : 9821259704 / 9223272436<br />

ECO CAMP SITE: RECEIPT NO. RECEIPT DATE: / / 2007 DURATION: TYPE: Relax / Active / Corporate<br />

GUEST INFORMATION (PLEASE FILL IN BLOCK LETTERS & TICK WHERE APPLICABLE)<br />

<br />

NAME<br />

Sex: Male Female, Date of birth: / / Age: years<br />

(Cell) (Email) In Emergency Contact Name & Mobile No.<br />

↸ HOME Address<br />

W<strong>in</strong>g Flat No. Floor Build<strong>in</strong>g Lane Road Landmark<br />

City P<strong>in</strong> Code Country Phone <br />

OFFICE Address<br />

Company Name Office No. W<strong>in</strong>g Floor Build<strong>in</strong>g Lane Road<br />

City P<strong>in</strong> Code Country Phone Extn<br />

ECO-CAMP PARTICULARS<br />

<br />

Check-<strong>in</strong> Date: / / , Check-out: / / , Check-<strong>in</strong> Time: : AM/PM, Check-out Time: : AM/PM<br />

↸ Accommodation Type Cottages: Stone Cottage, Earth Cottage, Safari Cottage, Tree House Huts: Grass Hut, Log Hut Tents: Dome, Cabana<br />

Meal Request: Ja<strong>in</strong> Nos. / Vegetarian Nos.<br />

ECO JONE - A WORLD OF EXPERIENTIAL & FUN NATURE ADVENTURES IN THE WILD: WHAT WILL YOU DO THIS TIME? ☯<br />

Eco-camp<strong>in</strong>g Experience : Campfire, Night Walks, Bicycl<strong>in</strong>g, Nature Games, Nature Activities, Bullock Cart Rides, Folk Dances & Songs, Tree Plantation<br />

Corporate Off site (OMTP) : Team Fun-N-Learn, Team Bond<strong>in</strong>g, Team Build<strong>in</strong>g, Time Management, Leadership, Creativity & Lateral Th<strong>in</strong>k<strong>in</strong>g, Decision Mak<strong>in</strong>g␣<br />

On River Fun Water Sports<br />

Jungle Adventures<br />

On Sea Fun Water Sports<br />

: River cross<strong>in</strong>g, Kayak<strong>in</strong>g on KII OR KI, Canoe<strong>in</strong>g, Boat<strong>in</strong>g, White Water Raft<strong>in</strong>g, Raft Build<strong>in</strong>g, Sail<strong>in</strong>g, W<strong>in</strong>d Surf<strong>in</strong>g, Jet Ski<strong>in</strong>g<br />

: Guided Nature Trail, Trekk<strong>in</strong>g, Bird Watch<strong>in</strong>g, Jungle Night Camp<strong>in</strong>g, Jungle Safari, Jeep Safari, Natural Treasure Hunt, Cav<strong>in</strong>g<br />

: Snorkel<strong>in</strong>g, Scuba Div<strong>in</strong>g, Kayak<strong>in</strong>g on KII / KI, Glass Bottom Boat Cruise, Game Fish<strong>in</strong>g, Dolph<strong>in</strong> Watch<strong>in</strong>g, Speed Boat<strong>in</strong>g,<br />

Nature Workshop Fun Zone : Snake Alive! Paper Recycl<strong>in</strong>g, Colour Me Wild, Magic from Castaways, Pottery Interactive, Puppet Show, Environment Leadership<br />

Expedition High Adventures : Rappell<strong>in</strong>g, Rock climb<strong>in</strong>g, Mounta<strong>in</strong> Bik<strong>in</strong>g Valley Cross<strong>in</strong>g, Fly<strong>in</strong>g Fox, Burma Bridge, Tarzan Sw<strong>in</strong>g, Tyre Jump, Ski<strong>in</strong>g<br />

ECOMANTRA’S CAR ON HIRE & AIRPORT / HOME PICKUP LOGISTIC SERVICES<br />

<br />

I would like to EcoMantra to provide with us with transportation and logistic services of a Car: Indica, Qualis, Van OR Bus (18, 22, 27, 35 OR 50 seater) for<br />

days from date / /2007 at : AM / PM from Airport by Airl<strong>in</strong>es Flight No OR ↸ Home<br />

*Transportation is not a part of the package (except if otherwise mentioned) and will be charged extra as per preferences. Typically it cost Rs. 400 to 500 per person per day at<br />

maximum occupancy <strong>in</strong> the car / SUV / Bus. 15% EcoMantra service charges applicable on actual transport and package charges. Please provide complete details to our executive.<br />

I WOULD LIKE ECOMANTRA TO KEEP ME POSTED ON ITS PROGRAMS AND DESTINATIONS INDIA ACROSS INDIA<br />

␣<br />

Eco-camps, Dest<strong>in</strong>ations across India (select from list below), Programs, Nature Workshops, and Expeditions By Email, By Post, over phone, In Person<br />

<br />

␣Western Ghats of India – <strong>Maharashtra</strong>, Goa, Karnataka, Tamilnadu, and Kerala<br />

␣Himalayas of India – Uttaranchal, Himachal Pradesh, U.P, Sikkim, and West Bengal<br />

# Other Forests of India – Madhya Pradesh and North East<br />

# ␣Coral Islands – Andaman and Lakshwadeep<br />

PAYMENT RECEIPT: ECOMANTRA COUNTERFOIL<br />

a) Children below age 3 years are complimentary & those ABOVE AGE 10 YEARS must pay FULL camp charges. Children between 4 -10 years, Army Personnel & senior<br />

citizens above 58 years are provided 25% Discount.<br />

b) Indemnity form signed? YES NO; it is compulsory to sign <strong>in</strong>demnity form to participate <strong>in</strong> Adventure activities. Parents and/or Legal Guardians must sign for<br />

participants under the age of 18.<br />

Received with thanks from _____________________________________________, the sum of Indian Rupees ___________________________________________________ only <strong>in</strong><br />

(First Name)<br />

(Last Name)<br />

Cash OR Demand Draft No.____________________ Drawn on bank ______________________________________ Branch_____________ Dated / /2007<br />

<br />

Rs. _________________________ ___________________________<br />

FINAL INVOICE BILLING GUEST SIGNATURE AUTHORISED ECOMANTRA SIGNATORY


E C O M A N T R A ’ S E C O - C A M P ’ S R E S P O N S I B L E T O U R I S M<br />

P R I N C I P L E S , R U L E S & E C O G U I D E L I N E S<br />

PLEASE READ ECOMANTRA RULES, RESPONSIBLE PRINCIPLES AND ECO GUIDELINES THAT ARE IMPLEMENTED AT ECOMANTRA ECO CAMPS ALL<br />

ACROSS INDIA AND ESPECIALLY AT ITS MODEL ECO-CAMP “RIVERTRAIL”.<br />

RESPONSIBLE TRAVEL & ECO GUIDELINES – ECOMANTRA’S SUSTAINABLE ECO PRACTISES AT RIVERTRAIL ECO-CAMP ☯<br />

Local Culture & Sensibilities<br />

Interactive Nature Adventures<br />

Nature Workshops & Games<br />

Ecotourism Staff Orientation<br />

Green susta<strong>in</strong>able Architecture<br />

Air, Water & Soil Management<br />

Energy Management<br />

Water Management<br />

Waste Management<br />

: All EcoMantra camps and programs are designed to care of local culture and sensibilities and ensure that these are understood and appreciated by <strong>guest</strong>s.<br />

: Nature Adventures that are ways to experience different terra<strong>in</strong>s of Earth and are done on land, mounta<strong>in</strong> or water.<br />

: Interactive Nature Workshops & Nature Games are part of a typical EcoMantra camp, and are great Fun-N-Learn for both adults and children’s.<br />

: EcoMantra teams are cont<strong>in</strong>uously tra<strong>in</strong>ed <strong>in</strong> ecotourism pr<strong>in</strong>ciples; eco practices and new development seamlessly deliver genu<strong>in</strong>e ecotourism to its <strong>guest</strong>s.<br />

: Susta<strong>in</strong>able traditional and local Architecture (Ecotecture) techniques have been used <strong>in</strong> the construction and ma<strong>in</strong>tenance of EcoMantra Eco-camps.<br />

: Susta<strong>in</strong>able Air, Water and Soil management practices ensures its protection and conservation by adopt<strong>in</strong>g traditional non pollut<strong>in</strong>g technologies.<br />

: Energy Management is done at all EcoMantra eco –camps and beg<strong>in</strong>s with low energy architectural design to energy sav<strong>in</strong>g utilities and appliances.<br />

: Susta<strong>in</strong>able water conservation, collection and usage at EcoMantra Eco-camps ensure m<strong>in</strong>imal water usage and zero contam<strong>in</strong>ation.<br />

: Reduce, Reuse & Recycle practices of both Liquid and Solid Waste generated at EcoMantra eco-camps virtually elim<strong>in</strong>ates waste to zero.<br />

You can request “Ecotourism & Eco Practices Guidel<strong>in</strong>es” document <strong>in</strong> MS Word of Adobe PDF format over the email for detailed understand<strong>in</strong>g and orientation of ecotourism and<br />

its susta<strong>in</strong>able practices by writ<strong>in</strong>g to us at ecotourism@ecomantra.org or <strong>in</strong>fo@ecomantra.org. Thank you for your <strong>in</strong>terest <strong>in</strong> ecotourism and be<strong>in</strong>g a responsible traveler.<br />

PRE CAMP ARRIVAL INFORMATION<br />

1. As per camp<strong>in</strong>g tradition of multiple shar<strong>in</strong>g, we usually accommodate 4 to 10 eco traveler per cottage/ tent<br />

2. Be<strong>in</strong>g a camp we welcome other <strong>in</strong>habitants of the eco-camp <strong>in</strong>clud<strong>in</strong>g frogs, spiders and lizard etc. <strong>in</strong> our cottages.<br />

3. Dogs and other pets are not allowed at any EcoMantra camps for convenience of other <strong>guest</strong>s, and also typically all its camps have tra<strong>in</strong>ed camp guard dogs.<br />

ON ARRIVAL IN AN ECOMANTRA ECO-CAMP<br />

1. Please report your f<strong>in</strong>al number of participants to the Camp Manager as soon as you arrive, and hand <strong>in</strong> a list of participant names and ages along with Indemnity form signed<br />

by each member of your team / group.<br />

2. A member of the team will show you the camp site, your accommodation, give you necessary <strong><strong>in</strong>formation</strong> and make you acqua<strong>in</strong>ted with our Pr<strong>in</strong>ciples.<br />

DINING PRINCIPLES AND TIMING<br />

1. EcoMantra Eco-camps usually have 100% vegetarian kitchen & simple, healthy and wholesome vegetarian local cuis<strong>in</strong>e is served buffet style.<br />

2. The Camp D<strong>in</strong><strong>in</strong>g Area opens daily at 7:30 AM and closes <strong>in</strong> the even<strong>in</strong>g at 9:30 PM. D<strong>in</strong><strong>in</strong>g Tim<strong>in</strong>g might change as per your specific camp it<strong>in</strong>erary.<br />

NO ALCOHOL / NO SMOKING<br />

1. Alcoholic beverages are usually not sold/served at most EcoMantra Camps; nor can you carry/consume alcohol with you. Please check for exceptions.<br />

2. To avoid <strong>in</strong>convenience to <strong>guest</strong>s & our camp team, and prevent possibility of fire; you are requested to refra<strong>in</strong> from smok<strong>in</strong>g at EcoMantra Camps and Programs at all times.<br />

RIVERSIDE PRINCIPLES<br />

1. Wash<strong>in</strong>g up may only be done <strong>in</strong> the toilet <strong>block</strong> wash<strong>in</strong>g area <strong>in</strong>side the build<strong>in</strong>g - <strong>in</strong> no circumstances should you wash outside the camp or near the water body.<br />

2. Please remember that we have to live <strong>in</strong> harmony with nature and you must not throws th<strong>in</strong>gs <strong>in</strong>to the river or forest as this irresponsible actions damages our natural heritage.<br />

WATER & ADVENTURE SPORTS PRINCIPLES<br />

1. Climb<strong>in</strong>g the Camp Rappell<strong>in</strong>g and Rock climb<strong>in</strong>g cliff face and boat<strong>in</strong>g / Kayak<strong>in</strong>g / Raft<strong>in</strong>g / Boat<strong>in</strong>g etc. on your own is forbidden except under supervision and at their<br />

scheduled tim<strong>in</strong>gs, and with complete safety equipments and gear worn. Any leisure games should be restricted to the marked leisure zone of the camp site only.<br />

CAMP FIRE PRINCIPLES<br />

1. No trees or plants may be damaged, for example to be used as firewood at campfire. Only dead, fallen wood is collected for this purpose!<br />

2. In case of fire, <strong>please</strong> <strong>in</strong>form any member of the Camp staff at once! You can reach them <strong>in</strong> the office or d<strong>in</strong><strong>in</strong>g area.<br />

3. Naked flames (e.g. candles) are not allowed <strong>in</strong> the tent areas or tribal huts. If you have to use them <strong>in</strong> your cottages, select an area away from curta<strong>in</strong>s, bamboo and wood<br />

furniture and other <strong>in</strong>flammable items.<br />

SAFETY / FIRST AID PRINCIPLES<br />

1. There are first aid kits <strong>in</strong> the office and with our guides while you are trekk<strong>in</strong>g.<br />

2. You are requested to NOT carry children <strong>in</strong> arms with you on trekk<strong>in</strong>g or <strong>in</strong> the Watersports area as it entails the risk of hurt<strong>in</strong>g both the children <strong>in</strong> the event of a slipp<strong>in</strong>g.<br />

LIGHTS OUT AND NOISE NORMS<br />

1. We ask you to keep noise to a m<strong>in</strong>imum dur<strong>in</strong>g the complete camp<strong>in</strong>g period but especially between 10:30 PM and 6:30 AM. Stereo systems, TVs, DVD’s etc. are not allowed.<br />

2. Light out is 10:30 PM. Any program that needs to extend beyond 10:30 PM needs prior permission else EcoMantra team will not be able to provide services next day. Ecomantra<br />

team will not extend service after 11:00 PM except under emergency.<br />

LEAVE NO TRACE – IN CAMP AND ON DEPARTURE<br />

Please help prevent rubbish heaps! Please dispose of all rubbish daily by type <strong>in</strong> the large b<strong>in</strong>s <strong>in</strong> front of the Camp. We sort rubbish <strong>in</strong>to:<br />

1. Flowers and Fruits: On the EcoMantra’s Campsite and Trekk<strong>in</strong>g Areas the Scout pr<strong>in</strong>ciple applies. We protect plants and animals. Do not pluck flowers, fruits and plants. Leave<br />

them as they are and where they are. These <strong>in</strong>cludes any paper that can be either recycled or safely burned, plastic, t<strong>in</strong>s, glass and all similar recyclable materials.<br />

2. These must be carried back to city dump as garbage sort<strong>in</strong>g and pick<strong>in</strong>g facilities do not exists <strong>in</strong> nearby villages and everyth<strong>in</strong>g is than usually dumped strewn around<br />

3. Compost: All fruit and vegetable peel, kitchen waste, fallen leaves are fed to the Compost / Vermiculture pit or the bio methanation plant.<br />

We thank you for your attention and rely on your help. Please also observe our General Terms and Conditions.


GROUP LIABILITY RELEASE – READ CAREFULLY <br />

E C O M A N T R A C A M P I N G & A D V E N T U R E A C T I V I T I E S<br />

R E L E A S E & I N D E M N I T Y F O R M – P A G E 1<br />

PLEASE ENSURE THAT ALL THE GUESTS SIGN THE INDEMNITY CLAUSE ON THIS FORM AFTER THEY HAVE CAREFULLY READ THE SAME. THEIR SIGNAURE<br />

ON THIS FORM ABIDES THEM TO THE TERMS AND CONDITIONS, AND IS ABSOLUTELY REQUIRED FOR THEIR PARTICIPATION IN ANY ADVENTURE<br />

ACTIVITIES. IN ABSENCE OF THIS COMPLIANCE THEIR PARTICIPATION IN ANY ADVENTURE ACTIVIITY WILL BE DENIED.<br />

AS ONE OF THE NAMES ABOVE AND ON BEHALF OF ALL PERSONS LISTED, I HAVE READ THE TERMS AND CONDITIONS AND ACCEPT AND UNDERSTAND THAT THEY FORM PART OF THIS CONTRACT. I UNDERTAKE ON MY OWN BEHALF AND ON BEHALF<br />

OF ANY OTHER PERSONS FOR WHOM THIS IS A JOINT BOOKING TO ACCEPT THE TERMS AND CONDITIONS OF “ECOMANTRA NATURE AWARENESS & TRAVEL” AS PRINTED IN THIS FORM AND THE DECISIONS OF THE TRIP LEADERS THEY APPOINT.<br />

PARTICIPANTS ARE SOLELY RESPONSIBLE FOR THEIR BELONGINGS (VEHICLES, MOBILES, AND JEWELLERY ETC.). ECOMANTRA AND ITS RESORTS / CAMPSITES ALONG WITH ITS MANAGEMENT/PERSONNEL IS NOT RESPONSIBLE FOR ANY LOSS OR<br />

DAMAGE TO THE SAME. I, THE UNDERSIGNED, ALSO FULLY UNDERSTANDS AND AGREE THAT SINCE ECOMANTRA DO NOT RUN OR MANAGE RESORTS OR HOTELS AND HENCE STANDARDS OF AMENITIES LIKE ROOM SERVICE, 24 HOUR MEAL<br />

FACILITIES, BATH TOWELS ETC. CANNOT BE PROVIDED. SIMILARLY STANDARDS SUCH AS ACCOMMODATIONS, CONSTANT ELECTRICITY, TRANSPORT, AND MEDICAL SERVICE THAT I AM USED TO AT OTHER POPULAR RESORTS ARE ALSO NOT<br />

POSSIBLE AT CAMP SITES OR ECO-CAMPS. I ALSO UNDERSTAND THAT IN AN ACTIVE HOLIDAY VARIOUS UTILITIES SINCE THEY ARE HEAVILY USED (LIKE BOATS, KAYAKS ETC.) MIGHT NOT BE IN BRAND NEW CONDITION. THE SUGGESTED ACTIVITIES<br />

WILL NOT BE POSSIBLE IF I AM UNABLE TO MAINTAIN SCHEDULE SUGGESTED OR WEATHER OR FOR FORCE MAJEURE REASONS AND THAT I CANNOT BE COMPENSATED FOR THE SAME. I AGREE TO CONTRIBUTE TO KEEP THE ECO-CAMP CLEAN BY<br />

ENSURING THAT ALL CIGARETTE BUTTS ARE THROWN IN THE ASH TRAYS & BY CARRYING BACK ALL PLASTIC BAGS, PET/GLASS BOTTLES AND BEVERAGE CANS WITH ME.<br />

IN WITNESS WHERE OF, Signed on this date / / , at the City of:<br />

Group Leader Name:<br />

Group Leader Signature:<br />

INDIVIDUAL WAIVER OF LIABILITY AND RELEASE OF CLAIMS OF ALL PARTICIPANTS – READ CAREFULLY <br />

BY SIGNING THIS, YOU GIVE UP ALL RIGHTS TO LITIGATION AND OTHER FORMS OF ACTION:<br />

• I hereby release and discharge “EcoMantra Nature Awareness & Travel”, its officers, partners, directors, coaches, members, volunteers, agents, and employees (here<strong>in</strong> referred to<br />

collectively as “personnel”) from all claims, demands, actions, judgments, and executions which the undersigned’s heirs, successors, executors, adm<strong>in</strong>istrators, representatives<br />

or assigns may have, or claim to have, for any and or all personal <strong>in</strong>juries, known and unknown, and damages to property, real or personal, caused by, or aris<strong>in</strong>g, out of the<br />

participation <strong>in</strong> the activity of dry land tra<strong>in</strong><strong>in</strong>g (e.g. physical workouts) or dry land activities like trekk<strong>in</strong>g; or adventure sports of any k<strong>in</strong>d not limited to on water tra<strong>in</strong><strong>in</strong>g or<br />

practises <strong>in</strong>clud<strong>in</strong>g river raft<strong>in</strong>g, boat<strong>in</strong>g or kayak<strong>in</strong>g or canoe<strong>in</strong>g, jet ski, surf board<strong>in</strong>g etc. and <strong>in</strong>clud<strong>in</strong>g rappell<strong>in</strong>g, rock climb<strong>in</strong>g, mounta<strong>in</strong> bik<strong>in</strong>g, jeep safari etc.<br />

• I, the undersigned, fully understand, acknowledge and agree that this dryland or mounta<strong>in</strong> or water or adventure sport activity has <strong>in</strong>herent risks <strong>in</strong>volved, and I am fully aware of the nature<br />

of these risks, notwithstand<strong>in</strong>g these risks. I hereby waive any and all rights, claims, prospective causes of action, cause of action, etc. as heretofore enumerated, and I hereby assume any and<br />

all risk associated with my participation <strong>in</strong> this sport<strong>in</strong>g activity. I understand that paddl<strong>in</strong>g or boat<strong>in</strong>g or raft<strong>in</strong>g on lakes; reservoirs and rivers <strong>in</strong>volve certa<strong>in</strong> dangers, not all of which can be<br />

listed here. Among the more obvious and frequent are:<br />

a) Exposure to variable extremes <strong>in</strong> weather that may cause <strong>in</strong>jury due to heat or cold, and which may prevent or force route and it<strong>in</strong>erary changes.<br />

b) Contact with and possible immersion <strong>in</strong> cold water for undeterm<strong>in</strong>ed periods, lead<strong>in</strong>g to hypothermia and possible suffocation.<br />

c) Exposure to capsize and s<strong>in</strong>k<strong>in</strong>g, trees, rocks, rope entanglement, current patterns, flash floods and other possible sources of “<strong>in</strong> water” <strong>in</strong>jury and entrapment.<br />

d) Unfamiliar terra<strong>in</strong> and routes where rafts / paddle boats / canoes / kayaks could become separated from the party.<br />

e) Transport by public or private motor vehicle.<br />

f) Travel <strong>in</strong> remote locations with poor communications and <strong>in</strong>ability to get rescue or medical assistance easily or quickly.<br />

• I accept all of the risks and the possibility of death, personal <strong>in</strong>jury, property damage and loss result<strong>in</strong>g from my <strong>in</strong>volvement with kayak or canoe or raft<strong>in</strong>g practice, kayak<strong>in</strong>g, canoe<strong>in</strong>g,<br />

and / or raft<strong>in</strong>g activities. I acknowledge that the all camp sites / retreats / resorts / hotels operated by EcoMantra Nature Awareness & Travel, personnel have been available to fully expla<strong>in</strong> the<br />

various hazards and risks associated with activities undertaken.<br />

• I certify that I am physically capable and fit to participate <strong>in</strong> this activity and I have no medical conditions or needs other than those set out below. I confirm that I am 18 years of age or older. I<br />

agree to pay for all costs <strong>in</strong>curred by the all camp sites / retreats / resorts / hotels and camp programs operated and/or used by “EcoMantra Nature Awareness & Travel,” and/or its personnel,<br />

and The jurisdiction of India, should an action or lawsuit be launched on my behalf. Members must disclose medical history / <strong>in</strong>jury <strong><strong>in</strong>formation</strong> to “EcoMantra Nature Awareness & Travel,”<br />

executive/managers/coaches, who <strong>in</strong> turn reserve the right to refuse entry on to a camp an/or any of its adventure activities.<br />

• I, the undersigned, have read this waiver/release, and understand all of its terms and conditions. I execute it voluntarily and with full knowledge of its significances. I understand that it will be<br />

b<strong>in</strong>d<strong>in</strong>g, not only on me, but also on my heirs, next of k<strong>in</strong>, successors, executors, adm<strong>in</strong>istrators, personal representatives and assigns. I agree that, even though I may not live <strong>in</strong> India, the laws<br />

of the Republic of India and the by-laws govern this waiver of liability and release of claims and will be enforceable <strong>in</strong> any court of law.<br />

• I hereby acknowledge and consent to the collection, use or disclosure of my personal contact <strong><strong>in</strong>formation</strong> by EcoMantra Nature Awareness and Travel for purposes set out here<strong>in</strong>.<br />

EcoMantra is collect<strong>in</strong>g the above <strong><strong>in</strong>formation</strong> for the purposes, <strong>in</strong>clud<strong>in</strong>g but not limited to camp updates, news, and social and other events, practice schedules, program <strong><strong>in</strong>formation</strong>,<br />

volunteer requests, and send<strong>in</strong>g official notices. I further acknowledge that the EcoMantra is not responsible or liable for the misuse of any of my personal contact <strong><strong>in</strong>formation</strong> beyond its<br />

control though every possible care is taken to keep your <strong><strong>in</strong>formation</strong> out of bounds for non Ecomantra personnel (except<strong>in</strong>g Government of India officials).<br />

IN WITNESS WHERE OF, Signed on this date / / at the City of:<br />

<br />

Witness 1 Name:<br />

#Witness 1 Signature:<br />

Witness 2 Name:<br />

#Witness 2 Signature:<br />

SR. NAME OF ECO TRAVELER<br />

NO.<br />

1<br />

SEX<br />

M / F<br />

M / F<br />

MOBILE / RESI<br />

TELEPHONE NO.<br />

EMAIL ID<br />

ECO TRAVELER’S<br />

SIGNATURE<br />

2<br />

M / F<br />

3<br />

M / F<br />

4<br />

M / F<br />

5<br />

M / F<br />

6<br />

M / F<br />

7<br />

M / F<br />

8<br />

M / F<br />

ECOMANTRA ECO-CAMP APPLICATION, INFORMATION & INDEMNITY FORM PAGE 2 of 3


E C O M A N T R A C A M P I N G & A D V E N T U R E A C T I V I T I E S<br />

R E L E A S E & I N D E M N I T Y F O R M – P A G E 2<br />

PLEASE ENSURE THAT ALL THE GUESTS SIGN THE INDEMNITY CLAUSE ON THIS FORM AFTER THEY HAVE CAREFULLY READ THE SAME. THEIR<br />

SIGNAURE ON THIS FORM ABIDES THEM TO THE TERMS AND CONDITIONS, AND IS ABSOLUTELY REQUIRED FOR THEIR PARTICIPATION IN ANY<br />

ADVENTURE ACTIVITIES, IN ABSENCE OF WHICH THEIR PARTICIPATION WILL BE DENIED. (………CONTINUE FROM PAGE 1)<br />

SR.<br />

NO.<br />

9<br />

NAME OF ECO TRAVELER<br />

SEX<br />

M / F<br />

M / F<br />

MOBILE / RESI<br />

TELEPHONE NO.<br />

EMAIL ID<br />

ECO TRAVELER’S<br />

SIGNATURE<br />

10<br />

M / F<br />

11<br />

M / F<br />

12<br />

M / F<br />

13<br />

M / F<br />

14<br />

M / F<br />

15<br />

M / F<br />

16<br />

M / F<br />

17<br />

M / F<br />

18<br />

M / F<br />

19<br />

M / F<br />

20<br />

M / F<br />

21<br />

M / F<br />

22<br />

M / F<br />

23<br />

M / F<br />

24<br />

M / F<br />

25<br />

M / F<br />

26<br />

M / F<br />

27<br />

M / F<br />

28<br />

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35<br />

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37<br />

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38<br />

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39<br />

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40<br />

M / F<br />

ECOMANTRA ECO-CAMP APPLICATION, INFORMATION & INDEMNITY FORM PAGE 3 of 3


␣<br />

P L E A S E C A R R Y T H I S C O P Y T O<br />

E C O M A N T R A C A M P<br />

THIS COPY MUST BE CARRIED TO THE ECO-CAMP AS PROOF OF INVOICE WITHOUT WHICH YOU WILL NOT BE ALLOWED IN<br />

Adm<strong>in</strong>istration Office: A-18, 4 Th Floor, Girdhar Nagar, RB Kadam Lane, LBS Marg, Ghatkopar (West), Mumbai 400086. INDIA.<br />

s<br />

TEL.: (9122) 65248646, : www.ecomantra.org / www.ecomantra.com : <strong>in</strong>fo@ecomantra.org : 9821259704 / 9223272436<br />

ECO CAMP SITE: RECEIPT NO. RECEIPT DATE: / / 2007 DURATION: TYPE: Relax / Active / Corporate<br />

GUEST INFORMATION (PLEASE PRINT)<br />

Group Head Name<br />

, Adults: Nos., Children: Nos. # Males: Nos. & Females: Nos.<br />

<br />

ECO-CAMP PARTICULARS<br />

<br />

Check-<strong>in</strong> Date: / / , Check-out: / / , Check-<strong>in</strong> Time: : AM/PM, Check-out Time: : AM/PM<br />

↸ Accommodation Type Cottages: Stone Cottage, Earth Cottage, Safari Cottage, Tree House Huts: Grass Hut, Log Hut Tents: Dome, Cabana<br />

Meal Request: Ja<strong>in</strong> Nos. / Vegetarian Nos.<br />

ECO JONE - A WORLD OF EXPERIENTIAL FUN NATURE ADVENTURES: WHAT WILL YOU DO THIS TIME? [To be <strong>fill</strong>ed <strong>in</strong> by EcoMantra ]<br />

Eco-camp<strong>in</strong>g Experience : Campfire, Night Walks, Bicycl<strong>in</strong>g, Nature Games, Nature Activities, Bullock Cart Rides, Folk Dances & Songs, Tree Plantation<br />

Corporate Off site (OMTP) : Team Fun-N-Learn, Team Bond<strong>in</strong>g, Team Build<strong>in</strong>g, Time Management, Leadership, Creativity & Lateral Th<strong>in</strong>k<strong>in</strong>g, Decision Mak<strong>in</strong>g␣<br />

On River Fun Water Sports<br />

Jungle Adventures<br />

On Sea Fun Water Sports<br />

: River cross<strong>in</strong>g, Kayak<strong>in</strong>g on KII OR KI, Canoe<strong>in</strong>g, Boat<strong>in</strong>g, White Water Raft<strong>in</strong>g, Raft Build<strong>in</strong>g, Sail<strong>in</strong>g, W<strong>in</strong>d Surf<strong>in</strong>g, Jet Ski<strong>in</strong>g<br />

: Guided Nature Trail, Trekk<strong>in</strong>g, Bird Watch<strong>in</strong>g, Jungle Night Camp<strong>in</strong>g, Jungle Safari, Jeep Safari, Natural Treasure Hunt, Cav<strong>in</strong>g<br />

: Snorkel<strong>in</strong>g, Scuba Div<strong>in</strong>g, Kayak<strong>in</strong>g on KII / KI, Glass Bottom Boat Cruise, Game Fish<strong>in</strong>g, Dolph<strong>in</strong> Watch<strong>in</strong>g, Speed Boat<strong>in</strong>g,<br />

Nature Workshop Fun Zone : Snake Alive! Paper Recycl<strong>in</strong>g, Colour Me Wild, Magic from Castaways, Pottery Interactive, Puppet Show, Environment Leadership<br />

Expedition High Adventures : Rappell<strong>in</strong>g, Rock climb<strong>in</strong>g, Mounta<strong>in</strong> Bik<strong>in</strong>g Valley Cross<strong>in</strong>g, Fly<strong>in</strong>g Fox, Burma Bridge, Tarzan Sw<strong>in</strong>g, Tyre Jump, Ski<strong>in</strong>g<br />

THINGS TO CARRY CHECK LIST FROM ECOMANTRA – READ CAREFULLY <br />

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Towels, napk<strong>in</strong>s, & toiletries (soap etc) are a must<br />

Mosquito or <strong>in</strong>sect repellent cream are required for families or groups travel<strong>in</strong>g<br />

with small children and those allergic to mosquito bites<br />

Sweater & Warm clothes <strong>in</strong> w<strong>in</strong>ter / W<strong>in</strong>dcheater or ra<strong>in</strong>coat <strong>in</strong> the monsoon<br />

Torch with spare batteries<br />

Extra pair of cloth<strong>in</strong>g for a change after waterfall visit and water sports activities<br />

like river cross<strong>in</strong>g etc.<br />

Strong, comfortable shoes and cotton socks (2 pairs m<strong>in</strong>imum) for trekk<strong>in</strong>g and<br />

Rappell<strong>in</strong>g<br />

Floaters or sandals (with straps at the back) for River-cross<strong>in</strong>g or River Raft<strong>in</strong>g<br />

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Cap, sunglasses, sunscreen, etc<br />

Shorts or any light material trousers for activities. Avoid tight fitt<strong>in</strong>g jeans and<br />

salwar kameez with dupatta dur<strong>in</strong>g activities.<br />

Personal toiletries and medic<strong>in</strong>es<br />

Lock and key for your bags for safety<br />

Avoid jewelry or any expensive personal items like watches, etc<br />

Optional items like Camera, b<strong>in</strong>oculars, if you wish. If possible, a small daypack<br />

or haversack to carry around dur<strong>in</strong>g mounta<strong>in</strong>-based activities<br />

This camp and <strong>in</strong>demnity form <strong>fill</strong>ed and signed by all!<br />

Lots of Enthusiasm and Good Cheer!<br />

ECOMANTRA CANCELLATION, PRIVACY & INFORMATION MANAGEMENT POLICIES – READ CAREFULLY <br />

# FEEDBACK: We look forward to your feedback to cont<strong>in</strong>uously improve our level of services. 10 % discount will be provided to eco travelers on future short duration eco-camps.<br />

# PRIVACY POLICY: Your personal <strong><strong>in</strong>formation</strong> is <strong>in</strong>tended to be used by EcoMantra and its representations and divisions <strong>in</strong> India and across the World. EcoMantra may also<br />

communicate this <strong><strong>in</strong>formation</strong> to the EcoMantra’s International Associates. If you do not agree to the use of your <strong><strong>in</strong>formation</strong> <strong>in</strong> this way, <strong>please</strong> check this box .<br />

# DATABASE MANAGEMENT: You have the statutory rights of access, modification, update and deletion of your personal <strong><strong>in</strong>formation</strong>. You can exercise these rights by writ<strong>in</strong>g to or e-mail<br />

to database@ecomantra.org<br />

# CANCELLATION POLICY: In the event of you not able to reach our campsite on the date of book<strong>in</strong>g for valid reasons OR if you wish to cancel your book<strong>in</strong>gs at EcoMantra eco-camp<br />

with<strong>in</strong> one hour of reach<strong>in</strong>g it, Ecomantra will refund 50% of your book<strong>in</strong>g amount on accommodation and food rates only (NOT on adventure activities) from its Mumbai Office by Cheque<br />

subject to its management discretion. If you wish to leave early from the camp for personal reasons or other reasons, No refund is possible<br />

………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………<br />

PAYMENT RECEIPT: CUSTOMER COUNTERFOIL (RECEIPT FOR PAYMENT RECEIVED WILL BE SENT BY COURIER)<br />

a) Children below age 3 years are complimentary & those ABOVE AGE 10 YEARS must pay FULL camp charges.<br />

b) Children between 4 -10 years, Army Personnel & senior citizens above 58 years are provided 25% Discount.<br />

c) Indemnity form signed? YES NO; it is compulsory to sign <strong>in</strong>demnity form to participate <strong>in</strong> Adventure activities. Parents and/or Legal Guardians must sign for<br />

participants under the age of 18.<br />

Received with thanks from _____________________________________________, the sum of Indian Rupees ___________________________________________________ only <strong>in</strong><br />

(First Name)<br />

(Last Name)<br />

Cash OR Demand Draft No.____________________ Drawn on bank ______________________________________ Branch_____________ Dated / /2007<br />

<br />

<br />

<br />

Rs. _________________________ ___________________________<br />

FINAL INVOICE BILLING GUEST SIGNATURE AUTHORISED ECOMANTRA SIGNATORY<br />

ECOMANTRA ECO-CAMP COPY PAGE 1 of 1

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