RELEASE, WAIVER AND AGREEMENT TO INDEMNIFY

In consideration for the receipt of free product samples for his or her participation in certain consumer product trials and reviews (the “Product Trials”) conducted by CC WELLNESS LLC D/B/A UNITED CONSORTIUM, a California limited liability company (the “Company”), the undersigned, being over the age of eighteen (18), for himself or herself and any personal representatives, heirs, and next of kin, hereby offers this full release, waiver of liability and agreement to indemnify.

IN FURTHER CONSIDERATION OF THE RECEIPT OF FREE PRODUCT SAMPLES, THE UNDERSIGNED HEREBY AGREES TO THE FOLLOWING:

1.)  The undersigned hereby acknowledges, agrees and represents that he or she has duly considered the risks associated with the Product Trials, which may include, but are not limited to allergic reactions, damages from toys and stains to sheets or clothing, and freely and knowingly enters into this release, waiver and agreement to indemnify.  

2.)  THE UNDERSIGNED HEREBY RELEASES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE the Company, its managers, members, employees, officers, agents and affiliates (hereinafter referred to as “releasees”) from all liability to the undersigned, his or her personal representatives, assigns, heirs, and next of kin for any loss or damage, and any claim or demands therefor on account of injury to the person or property or resulting in death of the undersigned, whether caused by the negligence of the releasees or otherwise while he or she is participating in the Product Trials.

3.)  THE UNDERSIGNED HEREBY AGREES TO INDEMNIFY AND HOLD HARMLESS the releasees and each of them from any loss, liability, damage, or cost they may incur due to his or her participation in the Product Trials, whether caused by the negligence of the releasees or otherwise.

4.)  THE UNDERSIGNED HEREBY ASSUMES FULL RESPONSIBILITY FOR ANY RISK OF BODILY INJURY, DEATH, OR PROPERTY DAMAGE TO THE UNDERSIGNED, WHICH OCCURS DURING OR ARISES FROM THE PRODUCT TRIALS.

5.)  The undersigned also agrees to obey all safety precautions as listed in writing or explained orally, to examine all ingredients of  the group of tested products to ensure no personal allergies or complications and agrees to ask for clarification when needed prior to using any products supplied during the Product Trials

6.)  The undersigned grants the Company an exclusive right to use any comments, photographs and all intellectual property, which may arise from the undersigned’s participation in the Product Trials, without further compensation.  

THE UNDERSIGNED further expressly agrees that the foregoing RELEASE, WAIVER AND AGREEMENT TO INDEMNIFY is intended to be as broad and inclusive as is permitted by the law of the State of California and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS this RELEASE, WAIVER AND AGREEMENT TO INDEMNIFY, and further agrees that no oral representations, statements, or inducement apart from the foregoing written agreement have been made.

   [Signature Below]

IN WITNESS WHEREOF, the undersigned has duly executed this Agreement as of __________________, 20___.

(Signature of Participant)

(Printed Name)

(Date)