RECIPIENT WAIVER AND RELEASE
In consideration of my receipt of a free 3D printed product (“Product”) from _________ (“Provider”), I hereby agree to and
acknowledge the following, which applies to my receipt and use of Product:
1. VOLUNTARY PARTICIPATION. I acknowledge that the Product may involve the use of new technologies, and
I acknowledge that there may be risks and dangers associated with these new technologies, including without limitation the risk of
bodily injury. Through my receipt of Product, I certify that I receive the Product voluntarily, that I am aware of these inherent
dangers. The Product you are receiving was designed, developed, and produced by laypersons, not medical professionals. It is not
intended for use as a medical device or to provide any medical or health-related benefit, and has not been reviewed (i) by the FDA or
other government agencies or (ii) The Enable Community Foundation (“ECF”). I further acknowledge that the information provided
with the Product is not intended as medical advice and does not replace the diagnostic and treatment services of physicians.
2. WAIVERS AND ASSUMPTION OF RISK: IN CONSIDERATION OF RECEIVING THE PRODUCT, I
HEREBY PERSONALLY ASSUME ALL RISKS IN CONNECTION WITH THE RECEIPT, FITTING OR USE OF THE
PRODUCT FOR ANY HARM, INJURY, LOSS OR DAMAGE THAT MAY BEFALL ME THROUGH THE RECEIPT, FITTING
OR USE OF THE PRODUCT, WHETHER FORESEEN OR UNFORESEEN, KNOW OR UKNOWN, OR SUSPECTED OR
UNSUSPECTED. THE PRODUCT IS PROVIDED TO ME ON AN “AS IS” BASIS AND WITHOUT ANY WARRANTY OF
ANY KIND. THE PROVIDER, DESIGNER OF THE PRODUCT IF THE PROVIDER IS NOT THE DESIGNER (“DESIGNER”),
AND MANUFACTURER OF THE PRODUCT IF THE PROVIDER OR THE DESIGNER IS NOT THE MANUFACTURER
(“MANUFACTURER”) EXPRESSLY DISCLAIM ALL WARRANTIES, EXPRESS, IMPLIED, STATUTORY OR OTHERWISE,
INCLUDING WITHOUT LIMITATION, THE IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A
PARTICULAR PURPOSE AND NONINFRINGEMENT OF THIRD PARTY RIGHTS. SOME JURISDICTIONS DO NOT
ALLOW THE EXCLUSION OF IMPLIED WARRANTIES, SO THE ABOVE EXCLUSION MAY NOT APPLY TO ME.
3. LIMITATION OF LIABILITY. IN NO EVENT SHALL PROVIDER, DESIGNER, OR MANUFACTURER BE
LIABLE TO ME FOR ANY DIRECT, INDIRECT, SPECIAL, PUNITIVE, INCIDENTAL OR CONSEQUENTIAL DAMAGES
ARISING OUT OF OR IN ANY WAY RELATED TO RECEIPT, FITTING OR USE OF THE PRODUCT, REGARDLESS OF
THE FORM OF ACTION, WHETHER IN CONTRACT, TORT (INCLUDING NEGLIGENCE), STRICT PRODUCT LIABILITY
OR OTHERWISE, EVEN IF PROVIDER, DESIGNER OR MANUFACTURER HAS BEEN ADVISED OF THE POSSIBILITY OF
SUCH DAMAGES. TO THE EXTENT SUCH LIMITATION DOES NOT APPLY THE TOTAL AMOUNT OF DAMAGES
SHALL BE LIMITED TO $100 IN AGGREGATE DAMAGES.
4. MEDICAL RELEASE & CONSENT. I hereby release and forever discharge Provider, Designer, Manufacturer
and ECF from any claim whatsoever that arises or may arise on account of any injury in connection with the receipt and use of the
Product, whether foreseen or unforeseen, known or unknown, suspected or unsuspected.
5. RELEASE OF LIABILITY. I understand I am responsible for my own conduct and decisions while receiving,
fitting and using the Product and further agree that this Waiver and Release will apply to any claim arising out of such receipt, fitting
or use, whether the claim is seen or unforeseen, known or unknown, or suspected or unsuspected. I, for myself and for my heirs,
beneficiaries, executors, administrators, successors and assigns, hereby release the Providers, Designers, Manufacturer and ECF and
their respective, as relevant, directors, officers, agents, employees, consultants, members, and affiliates, and all such parties’
respective successors and assigns, and, as applicable, heirs, beneficiaries, executors and administrators (all such released parties
referred to collectively as “Released Parties”) from all liability for any loss, liability, damage, injury or expense, whether arising
under contract, tort (including negligence), product liability, strict product liability, or otherwise, including without limitation any
liability for injury to my person or property or to the person or property of others, or otherwise, incurred by me through the receipt,
fitting and use of the Product. I UNDERSTAND THAT THIS RELEASE INCLUDES ALL CLAIMS AGAINST THE RELEASED
PARTIES ARISING FROM THE RELEASED PARTIES’ ORDINARY NEGLIGENCE, EVEN IF IT IS SOLELY OR
SEPARATELY NEGLIGENT.
With respect to the subject of this Release, I knowingly and voluntarily waive any and all rights and benefits conferred upon
me by the provisions of Section 1542 of the California Civil Code or by any similar law or provision, which section reads as follows:
WEST\263073099.1 A GENERAL RELEASE DOES NOT EXTEND TO CLAIMS WHICH THE CREDITOR DOES NOT KNOW
OR SUSPECT TO EXIST IN HIS OR HER FAVOR AT THE TIME OF EXECUTING THE RELEASE, WHICH
IF KNOWN BY HIM OR HER MUST HAVE MATERIALLY AFFECTED HIS OR HER SETTLEMENT WITH
THE DEBTOR.
In addition to the release set forth in this section, I agree to indemnify, defend and hold harmless the Released Parties from
and against any and all losses, liabilities, claims, actions, suits, demands, obligations, costs, expenses (including, without limitation,
reasonable attorneys’ fees and expenses) which result from, arise in connection with or are related in any way to the receipt, fitting or
use of the Product, except with respect for claims that cannot be waived as a matter of law, such as statutory indemnity.
6. INTERPRETATION. I agree that this Waiver and Release is intended to be as broad and inclusive as permitted by
the laws of the State of California, and that this Waiver and Release shall be governed by and interpreted in accordance with the laws
of the State of California. In the event any provision of this Waiver and Release is held invalid by a court, that shall not otherwise
affect the enforcement of the remaining provisions. In the unlikely event that an exception to the terms of this Waiver & Release
permits me to bring a cause of action against any of the Released Parties, or if I should later challenge the validity of this Waiver &
Release or any of its terms, the Courts of the State of California shall be my exclusive forum for seeking redress.
7. KNOWING AND VOLUNTARY EXECUTION. I have carefully read this Waiver and Release and fully
understand its contents. I AM AWARE THAT THIS IS A CONTRACT BETWEEN MYSELF AND THE PROVIDER AND THE
OTHER RELEASED PARTIES AND CONTAINS AN ASSUMPTION OF RISK AND A RELEASE OF LIABILITY, AND I SIGN
IT OF MY OWN FREE WILL. By signing this release, I certify that I am eighteen (18) years of age or older or have delivered the
consent of my parent or guardian to the Provider. This document when signed by me does not need to be signed by the Provider or
any other party and will be valid and binding upon me, and will be enforceable, without any party’s signature other than my own, will
be binding upon and will inure to the benefit of my successors and assigns and my heirs, beneficiaries, executors and administrators,
and the successors and assigns of the Provider, and cannot be amended or modified except in a writing signed by the undersigned or
the undersigned’s legal representative and by an authorized representative of the Provider. I affirm that I have been given adequate
time for my satisfactory review of this Waiver and Release and to ask questions about this Waiver and Release to my satisfaction, and
I understand that the terms of this Waiver and Release will control over any contrary oral or other written agreement or statement.
_________________________________________
Participant’s Signature
________________________________________
Witness’s Signature
_________________________________________
Participant’s Printed Name
________________________________________
Witness’s Printed Name
________________________________________
Date (MM/DD/YYYY)
________________________________________
Date (MM/DD/YYYY)
Consent of Parent or Guardian: [Please also sign below if the person signing the Waiver and Release is under the age of 18.]
I hereby represent that I am the parent and/or legal guardian of the minor (the “Minor”). who has signed the above Recipient
Waiver and Release. I hereby confirm that I have carefully read and fully understand everything contained in this Release and that I
consent to the execution of this Release by the Minor and join in and affirm all of the foregoing on the Minor’s and my own
behalf. Moreover, neither we nor the Minor will attempt at any time or for any reason to revoke or disaffirm any of the foregoing
consents, waivers, releases or agreements.
_________________________________________
Parent/Guardian’s Signature
________________________________________
Witness’s Signature
_________________________________________
Parent/Guardian’s Printed Name
________________________________________
Witness’s Printed Name
________________________________________
Date (MM/DD/YYYY)
________________________________________
Date (MM/DD/YYYY)
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