Registration Form
Your registration form and first payment must be received prior to 13th October, 2018.
Contact Information
Full Name *
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Email Address *
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Confirm Email Address *
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Phone Number (include country code) *
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Mailing Address *
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City *
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State/Province *
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Zip/Postal Code *
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Country *
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Check to confirm: I have a current passport that is valid at least six months past the workshop dates, and I am familiar with the visa requirements and processing times for my country. *
Required
Job Title *
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Organization/Company Name *
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Other/Comments
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Gender *
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Personal Needs
Please complete the following information to ensure that your needs can be met at the workshop and to assist in finalizing the logistical arrangements. The venue can accommodate most dietary needs if notified in advance.
Please note any special dietary needs and/or food allergies.
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Smoker? *
Required
Snorer? *
Required
Please specify any known health or fitness problems/concerns that the instructors should be aware of during the workshop that could affect your ability to participate in program activities.
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Emergency Contact
Emergency Contact Name *
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Emergency Contact Phone (include country code) *
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Indemnification
I agree to hold harmless and defend Roy Group Leadership Inc. (NatuR&D) and their directors, officers, employees, agents, consultants, stockholders and affiliates from and against any and all losses, damages, injuries, obligations, liabilities, demands, actions, suits, settlements, judgements, claims, costs and expenses (including but not limited to reasonable attorney's fees and costs), whether or not involving a third party claim, arising out of, based upon or resulting from, directly or indirectly, my participation in the workshop immersion program. I also agree that if any portion of this Indemnification is held to be invalid the balance, notwithstanding, shall continue in full force and effect.
Please initial here to signify that you agree to the Indemnification terms. *
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Intellectual Property
I grant Roy Group Leadership Inc. (NatuR&D) hosting this immersion permission to use all work performed by me as demonstrative materials for educational and promotional purposes and may invite the registrant to more openly share the work to the broader network of biomimics and participate in biomimicry initiatives. The registrant owns their own work completed over the course of the immersion. In the case of team projects, ownership of work products is equally shared amongst the individuals of the team.
Please initial here to signify that you agree to the use terms of Intellectual Property. *
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Photo/Video Release
I hereby authorize Roy Group Leadership Inc. (NatuR&D) the rights to use, reproduce, and/or publish photographs and/or video that may pertain to me - including my image, likeness and /or voice - without compensation. I understand that this material may be used in various publications, public affairs releases, recruitment materials, broadcast public service advertising or for other related endeavours. This material may also appear on the websites of Roy Group Leadership Inc. (NatuR&D) and any workshop-sponsoring partners. This authorization is continuous and may only be withdrawn by my specific rescission of this authorization. Consequently, Roy Group Leadership Inc. (NatuR&D) and sponsors may publish materials, use my name, photograph, and/or make reference to me in any manner that Roy Group Leadership Inc. (NatuR&D) and sponsors deem appropriate in order to promote/ publicize service opportunities.

I do permit and authorize Roy Group Leadership Inc. (NatuR&D) to use any and all images, diagrams, illustrations or video that I share with them via platforms (email, image transfer service, etc.). I represent and warrant that these images are original and created by me and that I have the right and authority to enter into this agreement. I permit Roy Group Leadership Inc. (NatuR&D) to use my images without photographer attribution for purposes related to the mission of Roy Group Leadership Inc. (NatuR&D) including publicity, marketing, and promotion of Roy Group Leadership Inc. (NatuR&D) and its various programs (including use on publicity sites such as Facebook and LinkedIn). I waive any right to inspect or approve the finished product, or any material in which Roy Group Leadership Inc. (NatuR&D) may eventually use my image.

Please initial here to signify that you agree to the terms of the Photo/Video Release. *
Your answer
Cancellation and Workshop Fee Refund Policy
If a registrant’s participation in the workshop should need to be terminated or cancelled due to an emergency situation (such as a medical or family emergency) and the reason is accepted by Roy Group Leadership Inc. (NatuR&D), a tuition refund will be considered under the following terms:
Cancellation will be recognized in a formal letter to Roy Group Leadership Inc. (NatuR&D) from the registrant. The registrant may send the letter via electronic format, but it must be dated and signed. In the case of cancellation by the registrant, a partial refund or credit toward a future workshop may be considered on a case-by-case basis taking into account costs incurred by Roy Group Leadership Inc. (NatuR&D).

The first payment is due upon registration and the initial deposit amount of $500 is not refundable when the registrant decides to terminate their participation for reasons that could have been prevented or are resolvable, such as errors in time management or poor financial planning.

Registrants are responsible for the knowledge of and securing any required visas for attending the workshop. When the registrant registers for the immersion workshop, it is with a full understanding of the registrant’s local embassy processing policies and timelines.

No refunds will be offered if registrant cancels after the final registration deadline (12th October, 2018).

If the workshop is cancelled by Roy Group Leadership Inc. (NatuR&D), the workshop fees will be refunded in full.

Please initial here to signify that you agree to the terms of the Cancellation and Workshop Fee Refund Policy. *
Your answer
Important
THIS CONTRACT IS A BINDING AGREEMENT BETWEEN ROY GROUP LEADERSHIP INC. (NatuR&D) AND THE REGISTRANT. We will send a copy to your email address.
Please initial here to signify that you agree to the terms of this Contract. *
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Payment Options
Please indicate your method of payment. *
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