Assumption Of Risk, Waiver, Release And Indemnification Agreement

Warning: Please Read Carefully! By Signing This Document You Will Waive Your Right To Sue.

The undersigned wishes to participate in the Expedition to Antarctica with The Antarctic Company (hereinafter referred to as "TAC").

The undersigned is aware that TAC requires each participant in the Expedition to deliver to TAC a disclamer in the form herein before he/shi will be permitted to embark upon the Expedition.

The undersigned is aware that participation in the Expedition to Antarctica involves exposure to many risks, dangers and hazards that maybe greater than encounted in the usual mountaineering and skiing expeditions including but not limited to:

- remoteness of the Antarctic Continent from any modern facilities;

- travel and survival in complete wilderness;

- extreme weather conditions which can change rapidly;

- little-known terrain covered in ice and snow which can conceal unstable slopes and crevasses;

- inadequate physical fitness or endurance;

- lack of air traffic, air traffic control facilities;

- limited search and rescue infrastructure.

As a condition of TAC permitting the undersigned to embark on the Expedition, the undersigned for himself/herself and any of the undersigned's heirs, legal/personal representatives and executors agrees as follows:

1. To assume voluntarily all risks inherent in participating in this activity, including but not limited to those listed above, including, without limitation the risk of bodily injury, death and loss or damage to personal property and any costs and expenses resulting therefrom;

2. To waive voluntarily any and all claims that the undersigned may have against TAC, and to release TAC from all liability and not to sue TAC for damages, losses, injuries and expenses arising out of or resulting from the participation in the Expedition;

3. That the undersigned is medically and in other respects is fit and able to undertake this expedition;

4. That the undersigned is solely responsible for his/her own medical and life insurance coverage;

5. That the undersigned is voluntarily enters into this agreement and participates in the Expedition of his/her own free will;

6. That the terms of this agreement shall continue and be in effect after the expedition has ended and be binding upon the undersigned's heirs, next of kin, executors, administrators, and assigns, in the event of his/her death.

7. That this Agreement shall be governed by the South African Law and will be handled in the competent and fair courts in Cape Town, South Africa.

Signing this agreement I acknowledge that I have read and fully understood its terms prior to signing it. I am aware that by signing below, I am affecting my legal rights and liabilities and the legal rights and liabilities of my heirs, next of kin, executors, administrators and assigns in relation to TAC.

Signed on .............................. day of ................................. 200..................

Participant print full name: _________________________________________

Participant's Signature: ___________________________________________

Witness print full name: ___________________________________________

Signature of witness: ____________________________________________