The individual named below (referred to as "I" or "me") desires to participate in the Hunter Chiropractic & Wellness Center Inc and ChiroThin Weight Loss Program (the "Activity" In consideration of being permitted to participate in the Activity and in recognition of the ChiroThin's reliance hereon, I agree to all the terms and conditions set forth in this instrument (this "Release" I understand participation in the Activity and my use and consumption of any ChiroThin product or engaging in any weight loss program including the type that is to be used in conjunction with ChiroThin, have inherent risks to my health and well-being, including but not limited to headaches, nausea, dizziness, vomiting, fatigue, pain, gallbladder issues, loss of consciousness, shortness of breath and other ailments. I understand rapid weight loss of over 1-2 lbs. per week is considered to be excessive and may lead to ailments similar and in addition to those mentioned above. Therefore, I understand that my failure to follow the weight loss program exactly as described to me by my physician or chiropractor can result in severe, temporary and/or permanent medical conditions in addition to those mentioned above.
I will not consume any of the ChiroThin products if I am pregnant or think I might be pregnant. I understand that, as a dietary supplement, ChiroThin has not been approved by the FDA or any Federal or State authority.
I understand The ChiroThin Weight Loss Program is not meant to diagnose, treat or cure any disease or medical condition and that I am to undergo participation in the ChiroThin Weight Loss Program only under doctor supervision. I also understand that I should consult with my doctor prior to starting ANY exercise or nutritional supplement program.
I understand if I experience any ailment, including but not limited to those listed above, I should immediately stop using or consuming the ChiroThin product and consult my physician or go to the hospital emergency room.
I hereby consent to, and assume the risks associated with, the use and consumption of ChiroThin product and agree to follow the recommendations and instructions of my physician or chiropractor. I further agree not to use or consume any ChiroThin product without the advice, counsel, and recommendations of my physician. I hereby waive, release and discharge my physician(s), Hunter Chiropractic & Wellness Center, Inc., ChiroNutraceutical, Inc. (the "Companies"), their agents, servants, employees and affiliates (together the "Releasees") from any and all liability, claims, causes of action and demands for personal or bodily injury or death that I, or my personal representatives, might have or might hereafter acquire through my participation in the Activity. I covenant not to make or bring any such claim against the Companies or any other Releasee. I shall defend, indemnify, and hold harmless the Companies, and all other Releasees, against any and all losses, damages, liabilities, deficiencies, claims, actions, judgments, settlements, interest, awards, penalties, fines, costs, or expenses of whatever kind, including attorney fees, fees, the costs of enforcing any right to indemnification under this Release, and the cost of pursuing any insurance providers, incurred by the Companies, or any other Releasees, arising out or resulting from any claim of a third-party related to my participation in the Activity, including any claim related to my own negligence or the ordinary negligence of the Company.
BY SIGNING, I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTOOD ALL OF THE TERMS OF THIS RELEASE