Service Provider and Client desire to enter into this Agreement to set forth the terms and conditions on which Service Provider will provide services to Client from time-to-time. Therefore, in consideration of the mutual promises contained herein, the parties hereto agree as follows:
1. Services. Service Provider shall administer intravenous hydration therapy (the “Services”) to Client at such place and time as is mutually agreeable to the parties hereto.
2. Medical Condition. Client understands, represents, and warrants that Client is not pregnant and does not have heart, kidney, lung, liver, or any neurological problem(s). Client understands and agrees that if Client has any of the aforementioned conditions, Service Provider will be unable to provide services to Client. Client understands, represents, and warrants that Client has spoken with his or her primary care physician and received approval to obtain the Services.
3. Right to Refuse Service. Service Provider retains the right to refuse care or service based on Service Provider’s professional opinion. Service Provider also has the right (but not the obligation) to call 911 or refer Client to further medical attention if deemed necessary by Service Provider or any other health care provider.
4. Age. Client understands and agrees that to obtain services, Client must be must be 18 years or older. Client represents and warrants that Client is at least 18 years of age.
5. Results. Client understands that each individual is different, so Client recognizes and agrees that the Services may or may not provide the result Client seeks and expects.
6. Assumption of Risk. Client understands and agrees that intravenous access comes with potential risks, including but not limited to allergic reaction, infection, discomfort, bruising, pain, inflammation, phlebitis, infection, metabolic disturbances, hypothermia, embolism, cardiac arrest, and even death. Complete information in regard to procedure and risk will be given at time of service. Client knowingly, voluntarily, and fully assumes the risks associated with obtaining the Services from Service Provider.
7. Cancellation. Client understands and agrees that Service Provider reserves any specified time and date for Client. Accordingly, payments are non-refundable even if Client cancels the request for Service Provider’s services or changes the requested date of such services. Service Provider may choose, at Service Provider’s sole discretion, to provide a refund to Client or to charge Client a reduced rate in the event of a cancellation upon reasonable notice to Service Provider. Similarly, Service Provider may choose, at Service Provider’s sole discretion, to provide services to Client in the event that Client changes the date of an event. Notwithstanding the foregoing, Service Provider shall have no obligation to offer any refund, charge a reduced rate, or provide any additional or alternate services to Client if Client cancels the request for Service Provider’s services, cancels the event, or changes the date of the event.
8. Dispute Resolution. Client agrees to provide Service Provider with written notice of any dispute, claim, or controversy, of any sort or nature, arising out of the Services or relating to Service Provider, within six (6) months after any such claim, dispute, or controversy arises. Any failure to strictly follow the procedures delineated in this section shall constitute an unconditional waiver of any dispute, claims, or controversy that may exist or Client may have against Service Provider, its affiliates, owners, members, managers, officers, employees, agents, representatives, or contractors. Client agrees to pay Service Provider’s reasonable attorneys’ fees for defending a lawsuit in which the dispute resolution procedure defined in this section has not been strictly followed.
9. Release and Indemnity. Client releases Service Provider, its owners, members, officers, managers, agents, contractors, employees, licensees, and invitees (“Service Provider Group”) from any and all liability for, and agrees to indemnify and hold Service Provider Group harmless from and against, any and all losses, claims, expenses, costs, and damages, including but not limited to reasonable attorney’s fees, costs, or expenses, which are claimed of or sustained, suffered, paid, or incurred by Service Provider Group, irrespective of Service Provider Group’s negligence (except gross negligence), for reason of or in connection with any or any combination of the following: Client’s breach of or failure to fulfill any provision of this Agreement, whether such breach is material or not.
10. Limitation of Liability. Neither the Service Provider nor any of its AFFILIATES, OWNERS, MEMBERS, MANAGERS, OFFICERS, EMPLOYEES, AGENTS, REPRESENTATIVES, OR CONTRACTORS (each a “Related Party” and, collectively, the “Related Parties”) shall be liable for any loss, liability, damage, or expense arising out of or in connection with the Services, unless such loss, liability, damage, or expense shall be proven to result directly from the willful misconduct or negligent of such person. NONE OF THE RELATED PARTIES SHALL BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, OR PUNITIVE DAMAGES (EVEN IF SERVICE PROVIDER HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES).
IN NO EVENT WILL THE AGGREGATE LIABILITY OF SERVICE PROVIDER, ITS OWNERS, MEMBERS, MANAGERS, OFFICERS, EMPLOYEES, AGENTS, AND CONTRACTORS FOR ANY AND ALL OF CLIENT’S CLAIMS, OR ANY THIRD PARTY CLAIMS, AGAINST SERVICE PROVIDER AND/OR ITS OWNERS, MEMBERS, MANAGERS, OFFICERS, EMPLOYEES, AGENTS, AND CONTRACTORS), ARISING OUT OF OR RELATED TO, DIRECTLY OR INDIRECTLY, THE PERFORMANCE OR NONPERFORMANCE OF ANY SERVICES OR BY THE NEGLIGENCE, ACTIVE OR PASSIVE, OF SERVICE PROVIDER, EXCEED THE GREATER OF (A) THE AMOUNT OF FIVE HUNDRED DOLLARS ($500.00) OR (B) the fees actually paid to Service Provider hereunder. CLIENT AGREE THAT THIS LIMITATION OF LIABILITY REPRESENTS A REASONABLE ALLOCATION OF RISK. THIS ALLOCATION OF RISK IS A FUNDAMENTAL ELEMENT OF THIS AGREEMENT.
11. Entire Agreement. This Agreement constitutes the entire agreement between Client and Service Provider with regard to the subject matter hereof, and replaces and supersedes all other agreements or understandings, whether written or oral.
12. Waiver. Service Provider’s failure to enforce or demand strict compliance of any right or provisions in this Agreement will not constitute a waiver of such or any other provision.
13. Opportunity to Review. Client acknowledges that it has had an opportunity to review and has agreed to this Agreement prior to receiving any services by Service Provider.
14. Unenforceable Provisions. If any provision of this Agreement, or any portion thereof, is held to be invalid and unenforceable, then the remainder of this Agreement shall nevertheless remain in full force and effect.
15. Governing Law; Venue. All matters arising out of or relating to this Agreement shall be governed by and construed in accordance with the internal laws of the state of North Carolina without giving effect to any choice or conflict of law provision or rule. Any legal suit, action, or proceeding arising out of or relating to this Agreement shall be instituted in the federal courts of the United States of America or the courts of the state of North Carolina, in each case located in the city of Charlotte and county of Mecklenburg, and each party irrevocably submits to the exclusive jurisdiction of such courts in any such suit, action, or proceeding. The parties hereto irrevocably and unconditionally waive any objection to venue of any suit, action, or proceeding in such courts and irrevocably waive and agree not to plead or claim in any such court that any such suit, action, or proceeding brought in any such court has been brought in an inconvenient forum.
16. This form is valid for 1 year from completion date.