Assumption of Risks, click capsule Release of Liability, sickness Waiver of Claims and Indemnity Agreement.
By agreeing to this document, physician you will waive certain legal rights, including the right to sue.
PLEASE READ CAREFULLY!
TO: Quality Optical Shop Inc., their agents, owners, officers, affiliates, volunteers, participants, employees, and all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as “Quality Optical”):
IN CONSIDERATION OF Quality Optical allowing the participant described below to participate in trial(s) or activities, the participant agrees as follows on behalf of themselves, their spouse, children, parents, heirs, assigns, personal representatives and estate:
|1. I acknowledge that my participation in Quality Optical trials, testing, or general activities activities entails known and unanticipated risks that could result in physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity. The risks include, among other things: cuts and bruises; falling off of equipment; muscle and joint sprains and strains; broken wrists, ankles and legs; participants falling on each other resulting in broken bones and other serious injuries; flipping, running and bouncing off the walls can cause serious injury; colliding with or being landed on by others. Quality Optical employees have a difficult job to perform. They seek to create a safe environment but they are not infallible. They might be unaware of a participant’s health or abilities. They may give incomplete warnings or instructions and the equipment being used might malfunction. Traveling to and from locations raises the possibility of any manner of transportation accidents. I expressly agree and promise to accept and assume all of the risks existing in this activity. My participation in this activity is purely voluntary and I elect to participate in spite of the risks.|
|2. If I and/or my child/ward are injured, I acknowledge that I and/or my child/ward may require medical assistance, which I acknowledge will be at my own expense or the expense of my personal Insurer(s). I hereby represent/affirm that I have adequate insurance to provide coverage for such medical expenses. I understand and agree that Quality Optical will not pay for any cost or expenses incurred by me if I and/or my child/ward are injured.|
|3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Quality Optical and to waive any and all claims, demands, or causes of action, that I have or may have in the future against Quality Optical and to release Quality Optical from any and all liability for any loss, damage, expense or injury including death that I may suffer or that my family, heirs, assigns, personal representatives and estate may suffer as a result of my participating in Quality Optical activities DUE TO ANY CAUSE WHATSOEVER, INCLUDING NEGLIGENCE, BREACH OF CONTRACT, OR BREACH OF ANY STATUTORY OR OTHER DUTY OF CARE, INCLUDING ANY DUTY OF CARE OWED UNDER THE OCCUPIERS’ LIABILITY ACT, R.S.O. 1990, c. O. 2 ON THE PART OF Quality Optical AND FURTHER INCLUDING THE FAILURE ON THE PART OF Quality Optical TO SAFEGUARD OR PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS OF TRIAL(S), DEMO(S) OR ACTIVITIES (HEREINAFTER REFERRED TO AS “CLAIMS”).|
hereby waive any right I and/or my child/ward may have to a trial and agree that such dispute shall be brought within one year of the date of this Agreement and will be determined by binding arbitration before one arbitrator to be administered pursuant to the Arbitration Act (Ontario). I further agree that the arbitration will take place solely in the Province of Ontario and that the substantive law of Ontario shall apply. If, despite the representations made in this agreement, I or anyone on behalf of myself and/or my child/ward file or otherwise initiate a lawsuit against Quality Optical, in addition to my agreement to defend and indemnify Quality Optical, I agree: (i) that any litigation involving the parties to this agreement shall be brought solely within the Province of Ontario and shall be governed by the laws of Ontario, and (ii) to pay Quality Optical within 60 days of initiating or filing a lawsuit against Quality Optical liquidated damages in the amount of $5000 plus 12% interest per annum if payment is not made on time.
I have had sufficient opportunity to read this entire document. I have read and understood it and I agree to be bound by its terms. ONLY ONE PARTICIPANT IS ALLOWED PER AGREEMENT.