The Australian Burlesque Cruise February 2021 Registration Form
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Email *
Your First Name (as per passport) *
Your Last Name (as per passport) *
Phone Number *
Date of Birth (please enter as dd/mm/year) *
Gender (as per passport) *
Address *
Cabin Type *
Names of room mate/s (Please arrange your roommates before registering for the cruise.) *
Bed Configuration *
Your burlesque school (If any) *
Your burlesque stage name (if any) *
Burlesque experience *
Required
Clothing Size for T-Shirt in welcome pack. (In Australian Ladies Standard Sizing) *
Required
Travel Insurance Quote? (recommended - through Tickled Pink Travel) *
Required
Australian Citizen? *
Required
Dietary Requirements *
Required
In Case of Emergency (Name and Contact Number) *
Release and Waiver *
Required
Passenger Waiver & Release Form
 I understand that by attending the Burlesque Cruise 2020 I will be participating in various stretching, dance and fitness classes either in the format of a private class or a group fitness class held on the premises of Explorer Dream. I recognise that any fitness programs may involve strenuous physical activity including, but not limited to, cardiovascular conditioning and interval training, muscle strength and endurance training, flexibility, balance, co-ordination and other various fitness activities.

I understand that it is my responsibility to consult with a physician prior to and regarding my participation in classes or group fitness training. I represent and warrant that I am in good physical condition and do not suffer from any known disability or medical condition which would prevent or limit my participation in this exercise program, or that will be detrimental to my health if I participate in this activity.

I, my heirs or legal representatives fully understand that I may injure myself as a result of my attendance and subsequent participation in the Burlesque Cruise and I, my heirs or legal representatives release Tickled Pink Travel Pty Ltd ABN 82 146 139 513, Bubble Glamour Productions, ABN 97 612 382 055, Melanie Piantoni ABN 36697987242 and its agents, sponsors and instructors associated with The Burlesque Cruise from any claims, demands, and causes of action as a result of my voluntary participation and from any liability (including liability for their negligence and the negligence of others) now or in the future for conditions that I may obtain.

These conditions may include, but are not limited to, death, heart attacks, muscle strains, muscle pulls, muscle tears, broken bones, shin splints, bone dislocations, heart prostration, injuries to virtually all bones, injuries to neck or spine which may result in complete or partial paralysis, brain damage, serious injury to internal organs or muscular skeletal system, injuries to all joints, injuries to ligaments, tendons or muscles, bruising, miscarriage or any other illness, impairment or soreness that I may occur and affect my body, wellbeing, general health. I also understand that pregnant woman need a medical clearance before attending group fitness classes or an exercise program and should consult their physician before commencing or participating in any of the classes. I understand the dangers and risks of participating and/or practicing to participate in the above may result not only in serious injury, but may lead to serious impairment of my future abilities to earn a living, to engage in other business, social or recreational activities and general quality of life.
I am fully aware and agree to assume all responsibility for any risks, injuries or damages, known and unknown, which I might incur as a result of participating in the classes.

In the event of an emergency, I authorize medical attention from any licensed hospital, physician and/or medical personnel any treatment deemed necessary for my immediate care and agree that I will be responsible for payment of any and all medical services rendered. It must be noted that the absence of health insurance coverage and or travel insurance coverage does not make Tickled Pink Travel and/or Bubble Glamour Productions any of the associated sponsors, organisers or instructors of The Burlesque Cruise responsible for payment of any medical expenses.
Registration and Payment *
Terms & Conditions *
Required
We look forward to cruising with you! *
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