By checking the box below, I, the undersigned applicant (or the authorized parent, legal guardian, or representative of the equipment recipient), hereby acknowledge and voluntarily agree to the following:
1. Nature of Services. Elizabeth's Gift is a Tennessee nonprofit organization that provides mobility, medical, and adaptive equipment to individuals with disabilities at no cost. I understand that Elizabeth's Gift does not manufacture, design, or warranty any equipment provided, and that equipment may be new, refurbished, or previously used.
2. Assumption of Risk. I acknowledge that the receipt and use of mobility, medical, and adaptive equipment involves inherent risks, including but not limited to: equipment malfunction or failure, improper fit, skin irritation or pressure injury, falls, collision, and other bodily harm. I voluntarily accept and assume all such risks, both known and unknown, arising from the receipt, use, or possession of equipment provided by Elizabeth's Gift. I understand that it is my responsibility (or the responsibility of the recipient's guardian or healthcare provider) to evaluate the safety, suitability, and proper fit of any equipment received prior to use, and to consult with a qualified medical professional regarding appropriateness for the recipient's specific needs.
3. Release and Waiver of Liability. In consideration of receiving equipment from Elizabeth's Gift at no cost, I, on behalf of myself, the equipment recipient (if different), and our respective heirs, executors, administrators, assigns, and personal representatives, hereby release, waive, and forever discharge Elizabeth's Gift, together with its officers, directors, board members, employees, volunteers, agents, contractors, and representatives (collectively, the "Released Parties"), from any and all claims, demands, actions, causes of action, suits, liabilities, damages, costs, losses, or expenses of any kind whatsoever, whether known or unknown, arising out of or in any way related to the provision, condition, selection, delivery, use, maintenance, modification, or suitability of any equipment provided, to the fullest extent permitted by the laws of the State of Tennessee. This release includes, but is not limited to, claims based on the negligence of the Released Parties. This release does not apply to claims arising from the gross negligence or willful misconduct of the Released Parties.
4. Hold Harmless and Indemnification. I agree to indemnify, defend, and hold harmless the Released Parties from and against any and all claims, demands, damages, losses, liabilities, costs, and expenses (including reasonable attorneys' fees and court costs) arising out of or resulting from the receipt, use, misuse, or possession of equipment provided by Elizabeth's Gift, to the fullest extent permitted by law.
5. Equipment Disclaimer. I understand and acknowledge that Elizabeth's Gift makes no warranties or representations, express or implied, regarding any equipment provided, including but not limited to warranties of merchantability, fitness for a particular purpose, or suitability for the recipient's specific condition or needs. All equipment is provided "as is."
6. Authority to Agree. If I am executing this agreement on behalf of a minor child or an individual for whom I serve as parent, legal guardian, or authorized representative, I represent and warrant that I have full legal authority to enter into this agreement on their behalf, and I agree to be personally bound by its terms. I further agree that this release and waiver shall apply to any claims brought by or on behalf of such individual.
7. Governing Law. This agreement shall be governed by and construed in accordance with the laws of the State of Tennessee, without regard to its conflict of laws principles. Any dispute arising under this agreement shall be subject to the exclusive jurisdiction of the courts of the State of Tennessee.
8. Severability. If any provision of this agreement is held to be invalid, unenforceable, or void, the remaining provisions shall continue in full force and effect to the maximum extent permitted by law.
9. Entire Agreement. This agreement constitutes the entire understanding between the parties with respect to the subject matter herein and supersedes all prior or contemporaneous agreements, whether written or oral.
10. Acknowledgment. I have read this Release of Liability, Assumption of Risk, and Hold Harmless Agreement in its entirety. I fully understand its terms, and I check the box below voluntarily and with full knowledge of its legal significance.
