Traveler Medical Questionnaire & Liability Waiver

Personal Information

Full Name Trip Name / Date Date of Birth Phone Number Email Emergency Contact Name & Relationship Emergency Contact Phone

Medical History

1. Chronic medical conditions? No Yes Details (if yes) 2. Currently taking medications? No Yes List medications 3. Allergies (medication, food, insects)? No Yes Specify 4. Hospitalized/surgery in last 12 months? No Yes Details 5. Physical limitations? No Yes Describe 6. Seizures, fainting, altitude sickness? No Yes Details 7. Pregnant? No Yes 8. Dietary restrictions? No Yes Specify 9. Anything else we should know?

Medical Consent & Waiver

I authorize Snap Voyagers (operated by VTX, LLC) and designated personnel to secure emergency medical treatment for me if necessary. I understand I am financially responsible for all related costs.

I understand the risks associated with travel and outdoor activity, and agree to assume full responsibility for my participation.

I release Snap Voyagers, VTX, LLC, its agents, group leaders, and third-party providers from all liability related to injury, illness, or loss that may arise during the trip, except in cases of gross negligence or intentional misconduct.

I understand that I am strongly encouraged to purchase travel and health insurance.