Release of Liability, Waiver of all Possible Claims and Assumption of Risk
I hereby acknowledge that I have agreed to meet with
(the “HCP”)
At Alliston Physiotherapy and Sports Rehabilitation (the “Facility”) for
Physiotherapy (the“Services”) (Services provided).
I acknowledge and accept that there is a risk that I could be exposed to COVID-19 while attending the Facility. I also acknowledge and accept that while receiving the Services, the HCP may need to be closer to me than the recommended social distancing guidelines in order to assess and/or treat me. I acknowledge and confirm that I am willing to accept this risk as a condition of attending the Facility to receive Services from the HCP.
In consideration of the HCP agreeing to see me in person at the Facility, I agree to release the HCP and the Facility (if applicable), their officers, directors, employees, agents, and volunteers (the “Releasees”) from any and all causes of action, claims, demands, requests, damages, or any recourse whatsoever in respect of any personal injuries or other damages which may occur or arise as a result of exposure to COVID-19 during my visit to the Facility and/or through the provision of Services to me by the HCP.
I do hereby acknowledge and agree that the notwithstanding the generality of the foregoing, I declare that I will not commence litigation or otherwise seek to recover damages or other compensation against the Releases based on any action, claim, demand, request, loss, or any recourse whatsoever arising from any potential or actual exposure to COVID-19 while attending at the Facility and/or through the provision of services to me by the HCP. I further acknowledge that the Releasees can rely on this Release of Liability, Waiver of all Possible Claims and Assumption of Risk as a complete defense to any and all claims, damages, causes of action, or recourse, or liability that may arise at any time.
I have carefully reviewed this Release of Liability, Waiver of all Possible Claims and Assumption of Risk and I fully acknowledge that I fully understand the terms as set out above. I acknowledge that I am signing this Release of Liability, Waiver of all Possible Claims and Assumption of Risk voluntarily.