Legal Family Release Form

LEGAL FAMILY RELEASE FORM

This Family Release Agreement (the Agreement) is made as of between Releasor: , residing at , acting on behalf of the family members set forth in Schedule A and collectively referred to herein as "Releasors", and Releasee: , with principal place of business at (collectively "Releasee").

RECITALS

WHEREAS, on or about , certain events occurred involving (the Subject) that may give rise to claims by Releasors against Releasee; and

WHEREAS, the Releasors desire to compromise, settle, and release any and all claims, demands, causes of action, and liabilities of every nature and description, whether known or unknown, arising from or relating to the Subject and the events described above; and

WHEREAS, Releasee denies liability but is willing to accept this release in full settlement of any potential claims, subject to the terms and consideration set forth herein.

NOW THEREFORE

In consideration of the mutual covenants and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows:

1. DEFINITIONS

For purposes of this Agreement: "Claims" means any and all claims, causes of action, demands, liabilities, suits, losses, obligations, costs, expenses, and damages of any kind or character, whether statutory or common law, known or unknown, suspected or unsuspected, including but not limited to claims for wrongful death, personal injury, emotional distress, property damage, and any derivative claims brought by heirs, executors, administrators, guardians, or representatives.

2. RELEASE AND WAIVER

Releasors, on behalf of themselves and their heirs, assigns, successors, trustees, executors, administrators, agents and legal representatives, hereby irrevocably and unconditionally release, remise, and forever discharge Releasee and its past, present and future officers, directors, shareholders, employees, agents, affiliates, successors and assigns from any and all Claims arising out of or in any way connected with the Subject or the events occurring on or before the date of this Agreement. This release applies to all Claims whether known or unknown, suspected or unsuspected, and Releasors expressly waive any statutory rights they may have under applicable law to assert otherwise.

3. CONSIDERATION

In consideration for this release, Releasee agrees to provide the following to Releasors: . The total consideration to be paid is: . Payment, if any, will be made in accordance with the schedule specified herein and is a material inducement to this Agreement.

4. REPRESENTATIONS AND WARRANTIES

Each Releasor represents and warrants that: (a) the person signing this Agreement has full legal authority to execute this Agreement on behalf of the Releasors identified herein; (b) no assignment or transfer of any Claim released herein has been made; (c) Releasors have not previously settled or released any Claim by separate agreement except as disclosed in writing to Releasee; and (d) Releasors will not seek to circumvent the intent of this Agreement by pursuing derivative or indirect claims.

5. COVENANT NOT TO SUE AND INDEMNIFICATION

Releasors covenant and agree not to initiate, maintain, or permit to be initiated or maintained any lawsuit, arbitration, or administrative proceeding against Releasee with respect to any Claim released by this Agreement. Releasors further agree to indemnify, defend and hold harmless Releasee from and against any and all losses, liabilities, damages, costs and expenses (including reasonable attorneys' fees) arising out of any third-party claims asserted by any person who is or claims to be a beneficiary of any Claim released herein, where such claim arises out of facts or circumstances released by this Agreement.

6. CONFIDENTIALITY AND NON-DISPARAGEMENT

The parties agree that the terms and existence of this Agreement, including the consideration provided herein, shall be confidential and shall not be disclosed to any third party except as required by law, to tax or accounting professionals, or to legal counsel or immediate family for purposes of obtaining advice. Releasors and Releasee further agree not to make any public statements that disparage the other party in connection with the matters released by this Agreement.

7. SCHEDULE A — FAMILY MEMBERS COVERED

List full legal names and relationships of all family members and other persons on whose behalf this release is executed. Include date of birth where applicable and indicate legal status (e.g., heir, spouse, child, executor).

Includes minors: If checked, name of guardian executing on behalf of minor(s):

8. TAXES AND EXPENSES

Each party shall be responsible for its own taxes, reporting, and professional fees arising from the consideration paid under this Agreement. Releasee makes no representations regarding the tax consequences of this Agreement and Releasors acknowledge that they have had the opportunity to obtain independent tax advice.

9. NOTICES

All notices required or permitted under this Agreement shall be in writing and delivered to the parties at the addresses provided below by personal delivery, certified mail (return receipt requested), or overnight courier. Notices are effective upon receipt.

10. AMENDMENT; WAIVER; COUNTERPARTS

This Agreement may be amended or modified only by an instrument in writing signed by both parties. No waiver of any breach or default shall be deemed a waiver of any other or subsequent breach. This Agreement may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument. Signatures transmitted by facsimile or electronic image shall be binding as originals.

11. GOVERNING LAW; SEVERABILITY; ENTIRE AGREEMENT

This Agreement shall be governed by and construed in accordance with the internal laws of the state specified below without regard to conflict of law principles. If any provision of this Agreement is determined to be invalid or unenforceable by a court of competent jurisdiction, the remaining provisions shall remain in full force and effect. This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements and understandings, whether written or oral.

Governing law state:

12. ACKNOWLEDGMENTS

Releasors acknowledge that they have read this Agreement in its entirety, that they understand its terms, that they enter into it voluntarily and of their own free will, and that they have been given the opportunity to consult with independent legal counsel prior to executing this Agreement.

Releasor represents: I have read and understand this release and execute it knowingly and voluntarily.

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