RELEASE OF LIABILITY AND ASSUMPTION OF RISK (please scroll to read entire waiver)
The individual named below (referred to as “I” or “me”) desires to enter the premises of Acumed LLC Mobile Lab, an Oregon medical device company mobile cadaver lab (the “Company”) located at various locations (the “Premises”) to engage in hands-on cadaveric training using Acumed producs (the “Activity”). In consideration of being permitted by the Company to be on the Premises and engage in the Activity and in recognition of the Company's reliance hereon, I agree to all the terms and conditions set forth in this agreement (this “Release”). In accordance with the Company’s policy, I understand I must sign the following Release prior to participating in the Activity.
1. I am aware and understand that the Activity is a potentially dangerous activity and involves the risk of serious injury, disability, and/or death. I am also aware of the contagious nature of bacterial and viral diseases, including human immunodeficiency virus (HIV), hepatitis B (HBV), hepatitis C (HCV), and other blood borne pathogens (collectively, the “Disease”) and the risk that I may be exposed to or contract the Disease by being on the Premises and engaging in the Activity, which may result in illness, personal or psychological injury, pain, suffering, temporary or permanent disability, death, and/or financial loss. I acknowledge that these risks may result from or be compounded by the actions, omissions, or negligence of Company employees or others, including negligent emergency response or rescue operations of the Company. I understand that while the Company has implemented measures to reduce the risk of injury from the Activity and the spread of the Disease, the Company cannot guarantee that I will not be injured or become infected with the Disease or other infectious diseases while on the Premises or during my participation in the Activity and that being on the Premises and engaging in the Activity may increase my risk of contracting the Disease. NOTWITHSTANDING THESE RISKS, I ACKNOWLEDGE THAT I AM VOLUNTARILY ACCESSING THE PREMISES AND PARTICIPATING IN THE ACTIVITY WITH KNOWLEDGE OF THE DANGERS INVOLVED. I HEREBY AGREE TO ACCEPT AND ASSUME ALL RISKS OF ILLNESS, PERSONAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, TEMPORARY OR PERMANENT DISABILITY, DEATH, AND/OR FINANCIAL LOSS ARISING THEREFROM, WHETHER CAUSED BY THE ORDINARY NEGLIGENCE OF THE COMPANY OR OTHERWISE.
2. I hereby expressly waive and release any and all claims, now known or hereafter known, against the Company and its affiliates and its and their officers, directors, manager(s), employees, agents, shareholders, successors, and assigns (collectively, “Releasees”) on account of personal or psychological injury, illness, pain, suffering, temporary or permanent disability, death, or financial loss arising out of or attributable to my being on the Premises or participating in the Activity, whether arising out of the ordinary negligence of the Company or any Releasees or otherwise. I covenant not to make or bring any such claim against the Company or any other Releasee, and forever release and discharge the Company and all other Releasees from liability under such claims.
3. I confirm that I: (a) am in good health and proper physical condition and do not have any medical or other conditions that would impair my ability to participate in the Activity; (b) have received and read the universal guidelines and precautions, if applicable to the Activity, and all other applicable policies and procedures, training and safety rules in connection with the Activity, including Company’s blood borne pathogens exposure protocol; (c) will comply with all federal, state, and local laws, orders, directives, and guidelines related to the Activity and the Disease while on the Premises or participating in the Activity, including, without limitation, requirements related to hand sanitation, use of face coverings and any safety equipment provided by Company, including, without limitation, personal protective equipment (e.g., gowns, gloves, caps, shoe covers, and masks with eye protection); (d) will use extreme caution when using medical equipment, including sharp instruments; and (e) will not take any photographs or recordings while on the Premises or during the Activity, except that a surgeon may take photographs solely for education and training purposes. I will also follow all instructions, recommendations, and cautions of the Company at all times while on the Premises or during the Activity. If at any time I believe conditions to be unsafe, that I am no longer in proper physical condition to participate in the Activity, or I begin experiencing symptoms of the Disease, I will immediately discontinue further participation in the Activity. I acknowledge that the Company is relying on these statements to allow me to participate in the Activity.
4. I hereby consent to receive medical treatment deemed necessary if I am injured or require medical attention during my participation in the Activity. I understand and agree that I am solely responsible for all costs related to such medical treatment and any related medical transportation and/or evacuation. I hereby release, forever discharge, and hold harmless the Company from any claim based on such treatment or other medical services.
5. I understand that Company has provided one or more human anatomical specimens solely for the Activity (“Human Specimen”). I will not handle Human Specimen except within the scope of the Activity as directed by Company. I will not remove Human Specimen from the Premises or otherwise retain Human Specimen upon completion of the Activity. I will treat Human Specimen with dignity and respect, and I will comply with all applicable federal, state, and local laws regarding the storage, handling, and disposal of Human Specimen.
6. I understand and agree that during the Activity, I may be photographed, recorded and/or videotaped by the Company for internal, educational and/or promotional use. I represent that I am 18 years or older and voluntarily authorize the Company, its related entities, agents, officers, representatives, employees, assignees, and those acting pursuant to its authority, the right to photograph, record and/or videotape the Activity (“Content”) and to use, alter, copy, copyright, modify, publish, reproduce, and/or transmit such Content in any medium or format, including, without limitation, through websites and/or on social media channels (collectively, the “Works”).
7. I hereby agree to relinquish, give, and assign to the Company, its related entities, and those acting under its authority, all rights, title, and interest I may have in the Content and the Works, and waive all rights to payment or compensation thereto. I release and discharge the Company, its related entities, agents, officers, representatives, employees, assignees, and those acting pursuant to its authority, from any claim or cause of action, now known or later discovered, for, among other things, invasion of privacy, right of publicity, appropriation of likeness, and defamation arising out of or in connection with the use or distribution of the Content and Works.
8. I acknowledge that I may provide information to Company in connection with my participation in the Activity, including my name, email and mailing address, phone number and NPI number. I understand that Company’s policy is to protect my privacy and confidential information in accordance with applicable law, and the Company's Privacy Policy available at https://www.acumed.net/privacy/. I also understand that the Company may contact me in order to send me educational opportunities or marketing, promotional, and advertising material, which I may unsubscribe from at any time.
9. I, by signing and providing my phone number below, authorize the Company to contact me via text (SMS) at the phone number listed below using automated dialing technology for marketing, promotional, advertising, and educational purposes, which I may opt out and/or stop at any time. Not a condition for participation in the Activity. Message and data rates may apply.
10. This Release constitutes the sole and entire agreement of the Company and me with respect to the subject matter contained herein and supersedes all prior and contemporaneous understandings, agreements, representations, and warranties, both written and oral, with respect to such subject matter. If any term or provision of this Release is invalid, illegal, or unenforceable in any jurisdiction, such invalidity, illegality, or unenforceability shall not affect any other term or provision of this Release or invalidate or render unenforceable such term or provision in any other jurisdiction. This Release is binding on and shall inure to the benefit of the Company and me and our respective successors and assigns.
BY SIGNING, I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTOOD ALL OF THE TERMS OF THIS RELEASE AND THAT I AM VOLUNTARILY GIVING UP LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE THE COMPANY.
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