To: Science/PR Department Phone: (714) 434‐6500 (option 4) Fax: (714) 434‐7300 Email: [email protected] APPLICATION FORM Please note that you need to book your factory tour at least 2 weeks before tour date. Please fill out below: Name of Group/ School/ Organization Name of Person‐in‐charge / Group Leader Address of main contact for group: Contact information: Desired date and time of visit: Total # of visitors in group (minimum of 15) Tel: Fax: Email: / / ☐ 10:00 AM Monday – Friday ☐ 1:30 PM Tuesday, Thursday and Friday Adults (>18 yrs): Youth (12‐18 yrs): Children (5‐12 yrs): (grade: to ) (grade: to ) Special requests/remarks (if any) Transportation: ☐ Bus (# ) ☐ car (# ) Allow photos of group? ☐ Yes ☐ No (If Yes, we will send you a photo release form) How did you find out about the tour? (Please Specify) ☐ Friend/Family ☐ Other’s Recommendation ( ) ☐ Previous Visit ☐ Health Fair ☐Other Event ( ) ☐ Direct Mail ☐ Newspaper ☐ Other Media ( ) ☐ Yakult Website ☐ Yakult Facebook ☐ Yakult Twitter ☐ Other website / Social Media ( ) ☐ Others ( )  Please fax / email this form to us. For further information or any questions please call (714) 434‐ 6500 (option 4).  Please allow a minimum of 3 business days for us to respond to your request.  The leader of each group is required to sign a waiver of liability, assumption of risk and indemnity agreement for the members of the group. The waiver will be sent to you along with the factory tour safety guide after we’ve received your application form. Please send back the signed waiver to us through email or fax at least one week before your scheduled tour date.  Please note that live production cannot be guaranteed as a result of our production schedule being subject to change.  At least one adult (>18y) will need to be present throughout the tour for any group with children or youth.  We accept groups with a minimum of 15 people and a maximum of 60 people at a time.  There are three parking spaces for buses as well as plenty of regular parking spaces. Please let us know if you will be coming by bus.  Our photo release form will need to be signed by the leader of each group. Please obtain permission from all members (18 yrs and up) and all parent/guardian of members (under 18 yrs) before signing the photo release form.  Please note we will not be able to accept all applications for a factory tour.