In-Person Gathering

Contact Tracing

(for COVID-19 and other communicable illnesses)

While we have taken precautions (wearing masks, washing hands, avoiding touching common surfaces, and maintaining social distancing) against COVID-19, it is still vitally important that we track who was at the same place at the same time. That way, if somebody shows any symptoms of anything, we can share (anonymously) with the group so that all can remain safe and healthy.

Please leave your First Name and Email Address below to be added to our contact tracing list. 

If within 2 weeks of this event, you experience any illness, please contact the event organizer.

Thank you for helping us all stay safe and healthy!

This also serves as a liability waiver and photo/media release. Terms below.

The Health Collaborator Event Waiver/Release Form

I hereby waive and discharge The Health Collaborator, LLC and any organizations or individuals associated with this event (including but not limited to municipalities, sponsors, and any employees or associates thereof), from all liability as a result of my participation in this event, whether caused by negligence or otherwise.

I understand that accidents, with fatalities, minor or serious bodily injury and/or property damage can occur during any outdoor physical activity, as a result of negligence or otherwise. I understand that this includes but is not limited to musculoskeletal injuries sustained as a result of tripping, falling, or otherwise coming into contact with the terrain, as well as exacerbations of chronic chronic health conditions, such as cardiovascular, pulmonary, neurological, integumentary, or other conditions.

I also understand that, as long as COVID-19 precautions are enforced by the state of Massachusetts, I agree to abide by these and any additional and more stringent precautions implemented by The Health Collaborator, LLC. This includes donning of mask/face covering when unable to maintain 6 feet of physical distancing between myself and another person, maintaining at least 6 feet physical distance between myself and another person at the event with whom I did not arrive, and avoiding touching common or otherwise unsanitized, high COVID-19 contraction risk surfaces. I understand that if I do not abide by these precautions, there may be a risk of contracting a communicable disease, and I agree to waive The Health Collaborator, LLC of any liability in the case that I do contract any communicable disease.

Knowing the risks involved I nevertheless agree to assume those risks and to release all of the persons or entities mentioned above for any injury, death, illness or property damages occurred (sic) during this event or in the travel to and from this event. I also release The Health Collaborator, LLC from all damage or injuries as a result of weather conditions during the event.

For and in consideration of The Health Collaborator, LLC permitting the participant to participate free of charge in this event, I, the Participant, by signing below, hereby voluntarily indemnifies, releases from liability and holds harmless The Health Collaborator, LLC for any accident, injury, illness, death, loss, damage to person or property, or other consequences suffered by Participant or any other person arising or resulting directly or indirectly from Participant’s participation in the event. In the event that the Participant is injured, Participant agrees to assume any financial obligation either through Participant’s personal health insurance or through some other means for any medical costs which Participant incurs. The Health Collaborator assumes no responsibility for any medical expenses, injury, illness, or damage suffered by the Participant in connection with the event in any way.

My electronic signature below also acknowledges my agreement that I may be videotaped, audio recorded, and/or photographed during the event and The Health Collaborator, LLC may use and modify images and recordings for any and all uses, including but not limited to advertisements and marketing without any compensation and in perpetuity.

Organizer Phone Contact

508-258-9274

Organizer Email Contact

Thank you!