English I EspanolSAN JUAN COUNTY PUBLIC HOSPITAL PARTICIPANT’S WAIVER, RELEASE, AND HOLD HARMLESS AGREEMENT (COORDINATED CARE PROGRAM)
Effective date: October 30, 2023
If you requested to enroll in clinical and coordinated care services provided by the Companies or such other third-party through a program (the “SJI Program”) administered by San Juan County Public Hospital District No. 1 (the “SJI District”), the following terms apply to your use of the Service:
WHEREAS, you have expressed the desire to partake in the SJI Program, free of cost, by your own free choice;
WHEREAS, due to the nature of the SJI Program, you acknowledge that the SJI District has no control over the services performed through the SJI Program.
NOW THEREFORE, in consideration of the SJI District allowing you to participate in the SJI Program, you hereby agree:
1. Assumption of Risk. You represent and warrant that you understand: (i) that the SJI Program could result in bodily injury, death, and/or personal injury; (ii) that participation in the SJI Program is being arranged at your request; and (iii) that the ability to participate in the SJI Program is of substantial personal benefit to you and thereby provides adequate consideration for this Agreement. YOU HEREBY ASSUME ALL RISK OF PROPERTY DAMAGE, INJURY, OR DEATH WHILE PARTICIPATING IN THE SJI PROGRAM.
2. Release, Indemnification, and Hold Harmless. FOR AND IN CONSIDERATION OF THE SJI DISTRICT ALLOWING YOU TO PARTICIPATE IN THE SJI PROGRAM, YOU FOR YOURSELF, YOUR MARITAL COMMUNITIES, HEIRS, EXECUTORS, SUCCESSORS AND ASSIGNS DO HEREBY FOREVER RELEASE, INDEMNIFY, AND HOLD HARMLESS THE SJI DISTRICT, ITS COMMISSIONERS, OFFICERS, EMPLOYEES, AND AGENTS FROM ALL CLAIMS, DAMAGES, DEMANDS, OR INJURIES OF ANY KIND (ANTICIPATED OR UNANTICIPATED) OR NATURE (UP TO AND INCLUDING DEATH), ARISING OUT OF OR RELATING TO YOUR PARTICIPATION IN THE SJI PROGRAM.
3. Entire Agreement. This Agreement is the entire agreement between the SJI District and you regarding participation in the SJI Program. There are no other oral or written agreements which have not been incorporated herein. This Agreement may only be modified in writing and signed by the SJI District and you. The representations, warranties, release, indemnification, and hold harmless shall survive the termination of this Agreement.
4. Severability. If any section of this Agreement is adjudicated to be invalid, such action shall not affect the validity of any section not so adjudicated.
You acknowledge that you have carefully read this WAIVER, RELEASE, AND HOLD HARMLESS AGREEMENT and fully understand that you are waiving any right that you may now, or hereafter, have to bring a legal action to assert any claim against San Juan County Public Hospital No. 1 in connection with your participation in the SJI Program.