Release of liability form
I, [Name], hereby acknowledge that I am the recipient or legal representative of the recipient of renting an in-home oxygen concentrator (hereinafter referred to as "the Equipment") provided by [Colorado Mountain Oxygen].
In consideration for the use of the Equipment, I agree to the following terms and conditions:
- Assumption of Risk: I understand and acknowledge that the use of the Equipment carries inherent risks and hazards. These risks include, but are not limited to, misuse of the Equipment, failure of the Equipment, allergic reactions, and other unforeseen complications. I voluntarily assume all such risks associated with the use of the Equipment.
- Release and Indemnity: I hereby release, waive, discharge, and covenant not to sue [Colorado Mountain Oxygen], its officers, directors, employees, agents, and affiliates (collectively referred to as "the Released Parties") from any and all liability, claims, demands, actions, or causes of action arising out of or related to the use of the Equipment, including but not limited to personal injury, property damage, or any other loss, whether caused by the negligence of the Released Parties or otherwise.
I agree to indemnify and hold harmless the Released Parties from and against any and all liabilities, damages, losses, costs, or expenses (including reasonable attorney fees) incurred as a result of any claims or suits brought against any of the Released Parties arising out of or related to my use of the Equipment.
- Responsibility and Maintenance: I understand that I am responsible for the proper use, care, and maintenance of the Equipment. I agree to use the Equipment in accordance with all instructions, guidelines, and applicable laws and regulations. I will promptly notify [Colorado Mountain Oxygen] of any malfunctions, damages, or concerns regarding the Equipment.
- Insurance Coverage: I understand that it is my responsibility to maintain appropriate insurance coverage, including liability insurance, to protect myself and others in the event of any incidents or accidents related to the use of the Equipment.
- Governing Law and Severability: This Release of Liability Form shall be governed by and construed in accordance with the laws of the state of [Colorado]. If any provision of this form is deemed invalid or unenforceable, the remaining provisions shall continue in full force and effect.
I have carefully read and fully understand the contents of this Release of Liability Form. I acknowledge that I am freely and voluntarily entering into this agreement, intending to be bound by its terms and conditions.
Signature: ___________________________
Printed Name: _______________________
Date: _______________________________