Client Policy Release Form

CLIENT POLICY RELEASE FORM

Parties and Contact Information

Recitals

WHEREAS, the Provider maintains policies and procedures governing conduct, access, confidentiality, and operational requirements applicable to services provided to clients (the policy or policies collectively, "Policies"); and

WHEREAS, the Client wishes to receive certain services from the Provider and acknowledges receipt of and agreement to the Policies, including any policy titled , effective on ; and

WHEREAS, the parties intend by this Client Policy Release Form to set forth the Client's acknowledgment of the Policies, the scope of services to be provided, payment terms, confidentiality obligations, and a mutual release with limited exceptions as described below.

Scope of Work

The Provider will perform the services described below. The Client acknowledges that the Policies may impose conditions on the manner, timing, and scope of performance.

Payment Terms

Client shall pay Provider in accordance with the following schedule and amounts. All payments are non-refundable except as expressly provided herein.

Term and Termination

This Agreement begins on and will continue until unless earlier terminated in accordance with this section.

Either party may terminate this Agreement for any reason upon days' prior written notice to the other party. Provider may immediately suspend services without prior notice if Client materially breaches the Policies or fails to pay amounts when due.

Confidentiality

The parties acknowledge that in performance of this Agreement each may receive Confidential Information of the other. Confidential Information means non-public information disclosed in any form that is designated confidential or that a reasonable person would understand to be confidential.

Each party agrees: (a) to use Confidential Information solely for the purposes of performing obligations under this Agreement; (b) to protect Confidential Information with at least the same degree of care it uses to protect its own confidential information but no less than reasonable care; and (c) not to disclose Confidential Information to any third party except to its employees, contractors, or advisors who have a need to know and are bound by confidentiality obligations no less protective than those herein.

Release and Acknowledgment of Policies

The Client acknowledges receipt of the Policies and their applicability to the services described herein. Subject to the limitations below, the Client hereby releases and discharges the Provider, its officers, directors, employees, agents, affiliates, successors and assigns from any and all claims, liabilities, demands, losses, causes of action, and damages arising out of or related to the Provider's good faith enforcement or application of the Policies, including operational decisions made pursuant to the Policies.

This release does not apply to claims arising from the Provider's gross negligence, willful misconduct, or fraud. The Client expressly acknowledges that nothing in this release limits any non-waivable statutory rights.

Governing Law; Entire Agreement

This Agreement shall be governed by and construed in accordance with the laws of the state of , without regard to choice-of-law principles.

This Agreement, together with any Policies expressly incorporated by reference herein, constitutes the entire agreement between the parties with respect to its subject matter and supersedes all prior and contemporaneous understandings, agreements, negotiations, and communications, whether written or oral. No amendment or modification of this Agreement will be binding unless in writing and signed by authorized representatives of both parties.

Representations and Certifications

Each party represents and warrants that it has the full right, power, and authority to enter into and perform this Agreement, and that the person signing below is authorized to bind the party for whom they sign.

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