ACKNOWLEDGMENT OF NO ESTABLISHMENT OF PATIENT-PHYSICIAN RELATIONSHIP, KNOWING ASSUMPTION OF RISK, AND RELEASE & WAIVER OF LIABILITY. I understand that Alliance Orthopedics the d/b/a All Be Healthy LLC ("Company" or "Us") (the “Practice”), including all of its employees and independent contractors, do not in any way intend to establish a patient-physician relationship with me by virtue of their presentation of any general or specific healthcare or wellness information, demonstration of clinical techniques or modalities, including demonstration on me, participation in physical events or competitions, or through any other method at this event, meeting, gathering, outing, or the like (collectively, “Event”) today. I acknowledge that I understand and agree that no such patient-physician relationship is being formed at this time. Accordingly, I understand and agree that if I am not already an existing patient of the Practice, I will not be considered a patient of the Practice after today’s event. I specifically acknowledge and agree that all physical techniques, modalities, and activities carry with them some risk which may include, but is not necessarily limited to, the possibility of harm, serious injury, and even death. I agree that I have voluntarily consented to undergo and take part in such activities or have such techniques or modalities performed on me with full awareness of these risks and have given my informed consent. I knowingly and voluntarily assume the risk associated with participation in any all of the activities, events, or demonstrations at today’s Event. Furthermore, I hereby expressly waive and release any and all claims, now known or hereafter known, against the Practice, and its officers, directors, manager(s), employees, agents, affiliates, shareholders/members, successors, and assigns (collectively, "Releasees"), arising out of or attributable to my participation in activity or voluntarily undergoing and physical demonstration, technique, or modality at the Event, whether arising out of the ordinary negligence of the Practice or any Releasees or otherwise. I covenant not to make or bring any such claim against the Practice or any other Releasee, and forever release and discharge the Practice and all other Releasees from liability under such claims. BY TYPING MY NAME AND SUBMITTING THIS FORM, I HEREBY ACKNOWLEDGE THAT I HAVE READ AND UNDERSTOOD ALL OF THE TERMS OF THIS DOCUMENT AND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE THE PRACTICE.