Whereas, Eternity Medicine Institute,
hereafter (EMI) - (the "Provider") and ___________________________ a
voluntary participant and employee of the Washoe County School
District, hereafter (the "Participant"), both enter into a medical
wellness clinical study agreement for a period of four months (120
days); and
Whereas, the Participant agrees and commits to follow EMI's medical
recommendations, consume the fluids and supplements provided; and
Whereas, the participant agrees to complete, on a daily basis (if
necessary), the Health Assessment (an online information questionnaire)
as well as the audio visual and reading assignments (provided at
www.eternitymedicine.com < http://www.eternitymedicine.com/ ); and
Whereas, the Provider agrees to furnish Participant with special
micro-clustered filtered alkaline fluids that are very high in
anti-oxidants and mineral supplements and to conduct a minimum of 3
different lab test results and 3 diagnostic medical exams conducted by
a Nevada Licensed Professionals, all at no cost to the Participant as
long as Participant remains in good standing during the 120 day
clinical trial; and
Whereas, all personal medical information will be kept absolutely
confidential and only through written request and approval by both
parties will any personal medical records acquired during this study be
released; and
Whereas, if Participant fails to faithfully complete the terms of the
clinical study, EMI has the right to immediately suspend all benefits
and supplements previously provided as well as require the Participant
to immediately return those sample supplements to EMI through his/her
employer; and
Whereas, EMI agrees to present a very special gift certificate to each
participant for their faithful participation in the clinical trial upon
completion and finally
Whereas, this EMI Wellness Clinical Trial is provided for the personal
benefit of each volunteering participant of Washoe County School
District, with the exclusive goals of reducing, substantially, the cost
of all health care for covered employees while concurrently providing a
personal pathway for each volunteer to a new paradigm shift in
preventative/primary medical care provided by the Physicians and Staff
of Eternity Medical Institute.
GENERAL RELEASE
As a condition to EMI’s provision of the services and products set
forth herein, the undersigned, and his successors in interest whether
specifically mentioned herein or not, do hereby release, and forever
discharge EMI and each of its subsidiaries, their respective directors,
officers, agents, whether specifically mentioned herein or not, of and
from any and all liability, actions, claims, demands, damages and
liabilities to person(s), expenses and compensation of every nature,
kind and character whatsoever, whether known or unknown, contingent or
actual, whether statutory, contract, or in tort on account of or in any
way connected with or related to EMI’s provision of the services and
products set forth herein. It is the express intention of the
undersigned that this Release be as broad as permitted by law.
Undersigned represents and warrants that execution hereof is free and
voluntary; that no inducements, threats, representations, or influences
of any kind were made or exerted by or on behalf of EMI; and that,
prior to the execution hereof, undersigned was given the opportunity,
if desired, to consult with counsel. This Release shall be
binding upon the undersigned, their heirs, successors and legal
representatives.
IN WITNESS WHEREOF, the undersigned has duly executed and delivered this Release as of the _____ day of ______________, 2010,
Dated the _________ day of ______________ 2010,
___________________________________,
_________________________________,
Name Kale Flagg, Chief Operating Officer EMI
____________________________________,
Address
____________________________________
Signature (A Volunteering Participant of WCSD)
PDF version can be download here.
