Authorization for Medical Treatment

As a condition of my participation in “A New Leash on Life” and in order that I may receive the necessary medical treatment in the event of an emergency whereby I may sustain injury or illness during participation in “A New Leash on Life,” I authorize any SPCA official to consent to and obtain necessary treatment or hospital care for such an injury or illness during the trip and I hereby release, discharge, indemnify and agree to hold Schenectady County SPCA, and its trustees, officers, employees, agents or servants harmless in the exercise of its authority.  I further hereby acknowledge that neither Schenectady County SPCA, nor any of the persons named above have any obligation to seek such treatment.

Should the need arise, my information may be given to any health care provider:

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