You are attesting that by clicking 'NEXT' and with the purchase of the COVIDCard you agree:

• that you are the person stated above submitting this form or a legal representative for the person submitted on this form
• 18 years of age or older
• that you understand that your COVIDCard is a supplemental COVID-19 Vaccination Record Card 
• that you understand that you should keep your original, paper, CDC COVID-19 Vaccination Record Card in a safe place and for use with official and/or legal documents and/or other situations where companies, organizations, and/or agencies are requesting the original paper CDC COVID-19 Vaccination Record Card
• that you understand that COVIDCard is a division of Centennial Pharmacy Services, Incorporated (Centennial) and its affiliates (collectively Centennial). By purchasing a COVIDCard, you and your affiliates, officers, directors, employees, volunteers, and agents expressly disclaim any responsibility for any company, group, organization, or agency not accepting COVIDCard as proof of your COVID-19 Vaccination. Your consent is given in light of this knowledge, and in consideration of receiving your COVIDCard. You, for yourself and your heirs, administrators, trustees, executors, assigns and successors in interest do hereby agree to release and hold harmless COVIDCard, WalletCOVIDCard.com, Centennial Pharmacy Services, Incorporated, its subsidiaries, divisions, affiliates, successors, assigns, officers, trustees, employees, volunteers and agents from and against any and all demands, damages, losses, costs, expenses, obligations, liabilities, claims, actions and cause of action (whether any of which is groundless or otherwise) of any nature whatsoever (including, without limitation, reasonable attorney’s fees and court costs) by reason of or resulting, in any way, from any and all acts, accidents, events, occurrences, omissions and the like related to, or arising out of, directly or indirectly, your receipt and use of this COVIDCard supplemental COVID-19 Vaccination Record Card. 
• not to use a false or misleading name or a ‎name you are not authorized to use. You must provide accurate and complete information for ‎your account or purchase. For the avoidance of doubt, all billing and registration information you provide must be truthful and accurate. Providing false, incomplete, or incorrect information could result in rejection of any ‎orders you make, and constitutes a breach of these Terms
• by confirming your purchase at the end of the checkout process, you agree to accept and pay for the item(s) requested

IN ADDITION TO THE FOREGOING, YOU EXPRESSLY ACKNOWLEDGE AND AGREE THAT PROVIDING INFORMATION THAT YOU KNOW OR SHOULD KNOW TO BE FALSE OR MISLEADING ABOUT, INTENDED TO REPRESENT, OR LIKELY TO CAUSE CONFUSION AS TO PROOF OF VACCINATION OF ANY TYPE MAY CONSTITUTE A VIOLATION OF LAW PUNISHABLE BY CIVIL OR CRIMINAL PENALTIES. FURTHER, YOU AGREE THAT AT ALL TIMES AS BETWEEN YOU AND COVIDCARD, YOU ARE SOLELY RESPONSIBLE FOR ANY MATERIALS, CONTENT, OR ANY OTHER INFORMATION YOU SUBMIT TO COVIDCARD RELATED TO PROOF OF VACCINATION OF ANY TYPE. FOR THE AVOIDANCE OF DOUBT, COVIDCARD IS UNDER NO OBLIGATION TO, AND WILL NOT UNDER ANY CIRCUMSTANCES, REVIEW FOR ACCURACY, ALTER, CORRECT, OR OTHERWISE MODIFY ANY MATERIALS, CONTENT, OR ANY OTHER INFORMATION YOU SUBMIT TO COVIDCARD RELATED TO PROOF OF VACCINATION OF ANY TYPE.