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1 EXCULPATORY CLAUSE in Consideration for Receiving  Form

1 EXCULPATORY CLAUSE in Consideration for Receiving Form

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Which I can receive like credit. Page 1 of 2 6. VOLUNTARY SIGNATURE. In signing this agreement I acknowledge and represent that I have read it understand it and sign it voluntarily as my own free act and deed sponsor has not made and I have not relied on any oral representations statements or inducements apart from the terms contained in this agreement. I agree to indemnify and hold harmless INDEMNITEES for any costs incurred to treat me even if an INDEMNITEE has signed hospital documentation...
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