Washington State University (WSU)

Assumption of Risk and Liability

I, __________________________________________________ , will participate in the Canine Canter, to be held on 4/6/2024.

Please type your first and last name below. 

Washington State University (WSU)

Assumption of Risk and Liability Continued...

In consideration for the opportunity to participate in the above-stated event, I voluntarily agree to assume all risks involved in my participation, including travel to and from the event. I understand the nature and extent of the activities in which I will be participating. I understand that if I voluntarily participate, I expose myself to risk of personal injury and/or death and property damage or loss including, but not limited to, the following:

Falling, slipping, crashing and colliding, and could result in injury, illness, emotional distress, death and/or property damage.

I agree to take full responsibility for all risks involved in my participation. I understand that if I participate in the activities, I will be exposed to risk of personal injury such as allergic reactions, skin irritation or infection, lacerations, bruising, muscle/bone/joint damage, broken limbs, dismemberment, permanent damage to various vital organs, and brain and/or central nervous system damage to include paralysis and/or death and/or property damage. I also recognize that there are both foreseeable and unforeseeable risks of serious personal injury and/or death as well as property damage that may occur that WSU cannot specifically anticipate and list here. I certify that I will comply with all staff instructions while participating.

Please sign your full legal name (type) below to serve as your electronic signature. Please type today's date below (Example- Jeff Mark Smith, May 8, 2022). 

Canine Canter 5k Fun Run/Walk

Consent to record imagery and voice

I ____________ (type full name), hereby grant permission to Washington State University (WSU) to photograph me or otherwise have images or voice recordings made (including but not limited to digital photographs, video or digital moving images and/or voice recordings), for WSU publication or promotional purposes in any medium (including but not limited to printed media, social media, newspaper, television, video, motion picture, or website on the internet). 

Please type your full name below.

*if you do not want digital images taken of you at the event, please email us at royalcanincaninecanter@gmail.com so that we can make accommodations and send you the appropriate consent form.

Canine Canter 5k Fun Run/Walk

Consent to record imagery and voice continued...

I additionally consent to the use of my name and/or interview comments with connection with WSU publication or promotional purposes in printed media, social media, newspaper, television, video, motion picture or web site on the internet. 

I understand that consent to use my likeness or voice recordings is not a condition of participating in the activity and that consent can be refused without any impact in the availability to fully participate in the program. No inducements or promises beyond my acceptance of an opportunity to promote WSU and its programs have been given to me.

Any other use of images and/or voice recordings , my name, and/or interview comments requires advance permission. I understand that I can revoke this consent at any time upon notice to WSU, at which time I will sign a copy of the denial for use of images or voice recordings. 

WSU STUDENTS: The Family Educational Rights and Privacy Act (FERPA) and the Washington Administrative Code 504-21-05- limit the release of personally identifiable information from student education records in the absence of a signed release from the student. The information described above may be protected by (FERPA) and WSU regulations, of this information, for the purposes specified above. 

I agree to use of digital images and/or voice recordings as set forth above:

Signature: Date:

Please sign your full legal name (type) below to serve as your electronic signature. Please type today's date below (Example- Jeff Mark Smith, May 8, 2022).  

*if you do not want digital images taken of you at the event, please email us at royalcanincaninecanter@gmail.com so that we can make accommodations and send you the appropriate consent form. 

Dog Waiver

Owner/Participant:_____________________

Dog Name:_______________________________

Disclaimer: 

I fully understand that WSU, WSU’s College of Veterinary Medicine, the Canine Club, and all Canine Canter sponsors are not responsible for any injury inflicted by my dog or unto my dog and self while at the Canine Canter. I understand that I am fully responsible for any injury or damage inflicted by my dog or unto my dog and/or self. All pictures taken at the Canine Canter of participants and pets may be used on the Canine Club website. I agree to allow the College of Veterinary Medicine’s use of my image for promotional use only. I agree to provide proof of my dog’s current rabies vaccination to the race officials on or before March 17th.

Please type your first and last name, followed by your dog's name. (Example: Jessica Smith, Fluffy)

Dog Waiver

Owner/Participant:_____________________

Dog Name:_______________________________

Disclaimer: 

I fully understand that WSU, WSU’s College of Veterinary Medicine, the Canine Club, and all Canine Canter sponsors are not responsible for any injury inflicted by my dog or unto my dog and self while at the Canine Canter. I understand that I am fully responsible for any injury or damage inflicted by my dog or unto my dog and/or self. All pictures taken at the Canine Canter of participants and pets may be used on the Canine Club website. I agree to allow the College of Veterinary Medicine’s use of my image for promotional use only. I agree to provide proof of my dog’s current rabies vaccination to the race officials on or before March 29th.

Signature:                                      Date:

Please sign your full legal name (type) below to serve as your electronic signature. Please type today's date below (Example- Jeff Mark Smith, May 8, 2022). 

*NOTE: in addition to signing this waiver, you must also email your dog's up-to-date vaccination records to royalcanincaninecanter@gmail.com by March 17th. Exceptions on the date may be considered given extenuating circumstances.