FORMS

I understand that with all physical activities around “the Van of Promise”, there is a risk of physical injury. As a participant of “Endless Possibilities” with “Life Path Institute,” I understand that there are inherent risks involved. I agree that in no way will I hold “Life Path Institute”, “the Van of Promise” and/or the employees of either entity responsible for any physical, mental, emotional, or psychological injuries that could occur around the van or outreach trailer while participating in activities orchestrated by “Life Path Institute,” “the Van of Promise” and/or the employees of either entity. I also understand that my personal insurance will be the primary carrier in the event of injury or accident resulting from any such activities.

As consideration for the services rendered by “the Van of Promise”, I also promise to indemnify, defend and hold “the Van of Promise”, “Life Path Institute”, and/or the employees of either entity harmless from and against any and all losses, liabilities, damages, fines, penalties and expenses (including attorneys’ fees and medical costs and expenses) arising from or resulting from any breach of the representations, warranties or covenants contained in this agreement, or otherwise related to any and all acts of behavior of the patient(s), which may include, without limitation, injury to patient at the facility or injury to a staff member of company or any other member of the public. In no event will “the Van of Promise”, “Life Path Institute” and/or the employees of either entity be held liable for special, consequential, exemplary or punitive damages, even if advised of their possible existence.