Non-Vaccination Release Agreement

NON-VACCINATION RELEASE AGREEMENT

This Non-Vaccination Release Agreement ("Agreement") is made and entered into as of , by and between Client Name: (entity type: Individual Entity ) with Address:

and Provider/Employer Name: (entity type: Individual Entity ) with Address:

RECITALS

WHEREAS, Provider/Employer provides services, employment, and/or access to premises where vaccination against communicable disease may be required as a condition of service, employment, or attendance; and

WHEREAS, Client affirms that Client declines to receive one or more specified vaccinations for reasons that may include medical, religious, or personal objections, as set forth below; and

WHEREAS, the parties desire to set forth their respective rights and obligations with respect to Client's non-vaccination status, including allocation of risk, release of claims, and procedures for notice and mitigation.

NOW, THEREFORE

In consideration of the mutual promises and covenants contained herein and other good and valuable consideration, the sufficiency of which is hereby acknowledged, the parties agree as follows:

1. DEFINITIONS

For purposes of this Agreement: "Claims" means all claims, demands, liabilities, actions, causes of action, suits, losses, damages, fines, penalties, costs and expenses (including attorneys' fees and costs) arising from or related to exposure to, contraction of, or transmission of any communicable disease; "Released Parties" means Provider/Employer and its officers, directors, employees, agents, affiliates, contractors and representatives.

2. ACKNOWLEDGMENT OF NON-VACCINATION

Client acknowledges and warrants that Client has voluntarily declined vaccination for the following vaccine(s) and/or reason(s):

Client certifies that the statements in the foregoing description are true and complete to the best of Client's knowledge and that Client understands that failure to disclose relevant medical information may affect the responsibilities allocated under this Agreement.

3. ASSUMPTION OF RISK

Client acknowledges that by declining vaccination Client assumes the risk of exposure to, contraction of, and transmission of communicable diseases, including but not limited to viral respiratory illnesses. Client knowingly and voluntarily accepts all such risks, whether known or unknown, foreseen or unforeseen.

4. RELEASE AND WAIVER

To the fullest extent permitted by law, Client hereby irrevocably releases and forever discharges the Released Parties from any and all Claims arising out of or relating to Client's non-vaccination, including but not limited to Claims for personal injury, illness, death, emotional distress, and economic loss, whether arising in contract, tort (including negligence), strict liability or otherwise.

This release does not extend to Claims resulting from the gross negligence or willful misconduct of a Released Party, provided that such exception shall be strictly construed.

5. INDEMNIFICATION

Client agrees to indemnify, defend and hold harmless the Released Parties from and against any and all Claims arising from Client's non-vaccination status, including reasonable attorneys' fees and costs incurred in defending any Claim brought by third parties against the Released Parties where such Claim is caused in whole or in part by Client's acts or omissions.

6. NO ADMISSION OF LIABILITY

This Agreement is not and shall not be construed as an admission of liability or wrongdoing by any party. The parties expressly deny any liability to the other and enter into this Agreement solely to allocate risk and set forth respective rights and obligations.

7. CONFIDENTIALITY AND MEDICAL INFORMATION

The parties agree that any medical information voluntarily disclosed in connection with this Agreement shall be treated as confidential and handled in accordance with applicable law. Client authorizes Provider/Employer to use disclosed medical information solely for purposes of safe operations and compliance with workplace policies.

8. TERM AND TERMINATION

This Agreement shall commence on the Effective Date and shall remain in force for the duration that Client remains non-vaccinated in the context of services, employment, or access to Provider/Employer premises, unless earlier terminated by mutual written agreement of the parties.

9. NOTICES

All notices required or permitted under this Agreement shall be in writing and delivered to the addresses set forth above or to such other address as a party may designate by written notice to the other party. Notices shall be effective upon receipt.

10. AMENDMENTS; WAIVER

No modification, amendment or waiver of any provision of this Agreement shall be effective unless in writing and signed by both parties. No waiver of any breach shall be deemed a waiver of any subsequent breach.

11. GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the state designated by the parties below, without regard to conflict of laws principles.

12. ENTIRE AGREEMENT; SEVERABILITY

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. If any provision of this Agreement is held to be invalid or unenforceable, the remaining provisions shall continue in full force and effect.

13. COUNTERPARTS; EXECUTION

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 delivered by electronic means shall be binding.

ADDITIONAL ACKNOWLEDGEMENTS

Client acknowledges that Client has had a reasonable opportunity to review this Agreement, to ask questions, and to seek independent legal advice. Client further acknowledges that Client signs this Agreement voluntarily and without coercion.

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