Common Contracts
1 similar Legally Binding Agreement contracts
NOTICE: THIS IS A LEGALLY BINDING AGREEMENTLegally Binding Agreement • April 6th, 2010
By signing this agreement, I, the undersigned, acting on his/her behalf or with full legal authority as parent or guardian of the participant, agree to release and on behalf of myself, my heirs, representatives, executors, administrators and assigns, HEREBY RELEASE its officers, agents, employees, representatives from any cause of action, claim or demand of any nature whatsoever, including but not limited to, a claim of NEGLIGENCE AND/OR WRONGFUL DEATH which I, my heirs, representatives, executors, administrators and assigns may now have, or have in the future against (doctor and office) on account of personal injury, property damage, death or accident of any kind, arising out of or in any way related to: (spinal examination/evaluation/etc.) , however the injury or damage is caused, including, but not limited to, the NEGLIGENCE AND/OR WRONGFUL DEATH of (doctor and office) , its officers, agents and employees.
