Client Consent Waiver Form

CLIENT CONSENT WAIVER FORM

PARTIES

Client Name:

Service Provider Name:

RECITALS

WHEREAS, Client desires to engage the Service Provider to perform the services described below and to grant certain consents and waivers to facilitate performance of those services;

WHEREAS, Service Provider represents that it possesses the necessary skill, training and licenses, as applicable, to perform such services in a professional manner; and

WHEREAS, the parties wish to set forth the terms, conditions, payment, confidentiality obligations, allocation of risk and governing law applicable to the relationship between them.

SCOPE OF WORK

The Service Provider will perform the services and deliverables as set forth below. The parties acknowledge that the described scope is the operative description of services for purposes of this Consent Waiver.

PAYMENT TERMS

Client agrees to pay Service Provider the amounts and on the schedule described below in exchange for the services rendered.

Payment is due in accordance with the schedule above. Unless otherwise stated, Client shall pay invoices within days of invoice receipt. Late payments shall accrue interest at (or the maximum legal rate if lower). Client shall also reimburse reasonable collection costs and attorneys' fees for delinquent amounts.

TERM AND TERMINATION

This Agreement commences on and ends on unless earlier terminated in accordance with this section.

Either party may terminate this Agreement for convenience upon providing days' prior written notice to the other party. Either party may terminate immediately for material breach if such breach remains uncured for more than days after written notice. Termination shall not relieve Client of the obligation to pay for services performed and expenses incurred prior to termination.

CONFIDENTIALITY

Each party shall maintain as confidential all non-public information disclosed by the other party that is identified as confidential or that a reasonable person would understand to be confidential given the nature of the information and the circumstances of disclosure ("Confidential Information"). Confidential Information shall not include information that: (a) is or becomes publicly known other than through breach of this Agreement; (b) is lawfully received from a third party without restriction; (c) is independently developed without use of the other party's Confidential Information; or (d) is required to be disclosed by law or by a competent court or regulatory authority, provided the disclosing party gives prompt written notice and cooperates in any protective action.

Confidentiality obligations shall continue for years following termination or expiration of this Agreement, except with respect to trade secrets, which shall remain protected for so long as they qualify as trade secrets under applicable law.

ACKNOWLEDGMENT, CONSENT AND WAIVER

Client acknowledges that the Services may involve risks, including but not limited to property damage, personal injury or other loss. Client represents that Client has had the opportunity to ask questions regarding the nature and extent of the Services and consents to Service Provider performing the Services under the terms of this Agreement.

To the fullest extent permitted by law, Client hereby waives, releases and forever discharges Service Provider and its officers, employees, agents and contractors from any and all claims, demands, causes of action and liabilities arising out of or in any way related to the Services, except for claims arising from Service Provider's gross negligence or willful misconduct. Client further agrees to indemnify and hold harmless Service Provider from any third-party claims arising from Client's acts or omissions in connection with the Services.

I acknowledge that I understand the risks associated with the Services and consent voluntarily.

I release Service Provider from claims as set forth in this Agreement, except for gross negligence or willful misconduct.

I authorize Service Provider to obtain emergency medical care for me (or for the client I represent) if reasonably necessary, and I agree to be responsible for associated costs.

GOVERNING LAW; DISPUTE RESOLUTION

This Agreement shall be governed by and construed in accordance with the laws of the State of without regard to conflict of laws principles. The parties agree to attempt to resolve disputes in good faith through negotiation. If resolution cannot be reached, the parties may pursue any remedy available at law or in equity in the courts of the chosen jurisdiction.

ENTIRE AGREEMENT

This Agreement, including its recitals and any attachments, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, representations and understandings, whether written or oral. Any amendment or modification must be in writing and signed by both parties.

MISCELLANEOUS PROVISIONS

If any provision of this Agreement is held invalid or unenforceable, the remaining provisions shall remain in full force and effect. The parties are independent contractors, and nothing in this Agreement shall be construed to create a partnership, joint venture or employment relationship. Notices must be in writing and delivered to the contact information provided above.

EXECUTION AND ACKNOWLEDGMENT

By signing below, the undersigned represent and warrant that they are authorized to bind the party for whom they sign and that they have read, understood and agree to be bound by the terms of this Consent Waiver Form.

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