RELEASE FORM LIABILITY
For Participant, Volunteer, and Family
Your acceptance is indicated by pressing the “Next” button. This constitutes your “digital signature” and is legally binding. If you are under 18 years of age, YOUR LEGAL GUARDIAN MUST PROCESS THIS FORM.
In consideration of my participation in The Prouty, I hereby agree on behalf of myself, my heirs, legatees, executors, administrators, and personal representatives, to release the organizers and volunteers involved in the planning, organizing and operation of The Prouty from liability for injury to me or my property caused by their negligence. I intend that the effect of this release shall be to release such organizers and volunteers from any liability to me arising from their failure, in any way, to use reasonable care in their activities pertaining to The Prouty. If I am under the age of eighteen years, then this release shall be signed on my behalf by my parent or guardian.
If I am injured, I hereby authorize the Medical Director (or his designate) of The Prouty to notify family members of my location and status.
By signing the event release, dog owners agree to assume all liability for any injuries or damage caused by their dog while participating in the Prouty. On the day of the Prouty, dogs must be licensed and up to date on vaccinations, including but not limited to rabies, bordetella, and distemper shots.
I also acknowledge and agree that if cycling I am required to wear an ANSI- and/or Snell-approved helmet during the entire ride, and I understand that it is recommended that I wear light, bright, or reflective clothing.
I hereby give my full permission for the Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center and its components to use my name and photograph in connection with this event.