Dubois Ruritan Club

EVENT REGISTRATION/RELEASE FORM

VEHICLE ACCIDENT WAIVER, RELEASE OF ALL LIABILITY AND ASSIGNMENT OF CLAIMS

Event Description: Dubois Ruritan Club, Annual Jeeps & More Cruise (Jeeps, motorcycles, convertibles, and any vehicle may participate). Jeeps and other vehicles shall cruise around on public highways, county roads and/or other roadways with the intent on stopping at several locations for breaks. The group shall end at a designated location where prizes shall be given away by means of a drawing with tickets (if applicable).

As consideration for being allowed to participate in the event(s) I agree as follows:

1. I acknowledge that any reference to Dubois Ruritan Club, for the purposes of this event as detailed in the above description, shall include the Dubois Ruritan Club, its members, event organizers, sponsors, volunteers, representatives, agents and/or Dubois Community Park.

2. I acknowledge the risks of contracting contagious diseases such as the COVID-19 virus, any other virus, flu or infections in general and release liability for myself, minors and anyone in my vehicle signing the event agreement sheet. I also understand it is my right to wear a protective face covering or not, and that I agree not to harass anyone choosing to wear a face covering or not. Any disagreements as such will result in being asked to leave the event. Additionally, if asked to wear protective face coverings at any of the locations we stop, it is your right not to enter that facility. It is not your right to argue with the owners, staff, Dubois Ruritan Club, et.al., etc. and will be asked to leave the event if such behavior is reported.

3. I acknowledge that vehicle activity is a potentially hazardous activity which carries with it the potential for death, serious injury and property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of equipment, vehicular traffic, actions of other people including, but not limited to, the Dubois Ruritan Club, et.al. These risks are not only inherent to the drivers, but are also present for passengers, spectators, and volunteers. I hereby assume all of the risks of participating, viewing and/or volunteering in this event. I also agree to be held completely liable for any and all minors (children under the age of 18) that are either passengers with me or that may be authorized by me to drive my vehicle. I realize and accept that unintentional liability may arise from negligence or carelessness on the part of the persons or entities organizing or conducting this event and hereby release them of all possible liability. I certify I am at least 18 years old. I agree and promise that I will not sue the Dubois Ruritan Club, et.al., and agree to pay all costs and all attorney fees that result from my action(s), civil or otherwise during this event, if caused by myself or passengers.

4. I certify that I do not have any physical or mental impairment that would prohibit my participation in the event. I acknowledge that this Accident Waiver and Release of Liability form will be used by the event holders, sponsors, and organizers of the event, in which I voluntarily agree to participate and that it will govern my actions and responsibilities at said event. I certify that I am not under the influence of any narcotic, alcohol or other drug that may impair my understanding or judgment and that I will not at any time during the event operate my vehicle under the influence of any narcotic, alcohol, or drug. I certify that I have adequate insurance to cover all medical claims, the vehicle and any other equipment and any damage or liability I may ultimately be found responsible for, during all travel to the point of my entry to the event, the event itself, the period between the end of the event and my return to my final destination. I further certify that I have all the insurance required by law and I am licensed and competent to operate a vehicle in a safe manner and my license has all endorsements or certificates required by my state of residence I further acknowledge that any minor operating my vehicle for the event shall have all required licenses and insurance coverage.

5. In consideration of my being permitted to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) Waive, Release and Discharge from any and all liability for my death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter accrue to me during the event or during my traveling to and from this event, the following entities or persons: Dubois Ruritan Club, et.al. , and (B) indemnify and hold harmless the entities or persons mentioned in this paragraph from any and all liabilities or claims made by other individuals or entities as a result of any of my actions during this event. Accordingly, I do hereby release and discharge Dubois Ruritan Club, et.al., from all claims, demands, and causes of action of every kind whatsoever for any death, damages and /or injuries which may result from my participation in this event. This shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

6. If I become incoherent or unconscious during this event, I hereby consent to receive medical treatment, which may be deemed advisable by law enforcement or licensed medical personnel in the event of injury, accident and or illnesses during the event. I agree to pay for any and all costs related to medical response, treatment, and transport on my behalf.

7. I certify I will wear the personal protective equipment while operating my vehicle during this event that is, or may be required by, the United States and/or any state in which my participation occurs and that my vehicle and all required personal protective equipment are in safe operational condition. I agree to abide by the directions/rules given by the organizers of this event and understand that my privilege to participate may be removed without refund if I am in violation of the rules set forth or acting/performing in an unsafe manner, or any manner disruptive to the operation of the event.

8. I agree to pay for all expenses (including but not limited to lodging, food, beverages, gasoline, oil, repairs and maintenance and any other costs or expense(s) I may incur) intending that Dubois Ruritan Club, et.al., shall be totally free of such costs and expenses.

9. I fully understand that there may be photographs or video footage taken throughout the event. I acknowledge and agree to participate in photo sharing and posting on websites such as Facebook, Snap Chat, Instagram, and other social media, but not solely limited to such. I also acknowledge that any minors in my care may be photographed or shown on any video footage as well. I hereby release Dubois Ruritan Club, et.al., from any and all claims based upon or arising out of the use, reproduction, distribution, display or performance of all or any part of the photographs or recordings, or any derivative thereof, including any claim of invasion of privacy or right of publicity.