Custom mouth guards may reduce the risk of injury but cannot expressly prevent or reduce the severity of injuries.
I hereby bind myself and my heirs, administrators, executors, successors, and assigns (collectively “I”, “me” or “my”) to forever release any claims, indemnify and hold harmless, Dr. Blair White, White Orthodontics, P.C., his corporations, agents, and employees, against whom suit may be brought, on account of injuries and/or damages sustained by me or my child. I further waive any liability , claims against, demands, causes of action, damages, losses or expenses relating to my sports and/or activities of choice while said custom mouthguard is used. I willingly and voluntarily assume all such risk or injury incidental to my, or my child’s, sport and/or activity and ALL risks by participation in said sport and/or activity.
Said custom mouthguards are intended for use during sports, athletic, or other physical activities only. They are not intended to be used to any type of orthodontic or dental treatment or therapy, including, but not limited to, use as retainers, night/occlusal guards, TMJ splints, etc. Dr. Blair White, his corporations, agents and employees bear no responsibility for when said custom mouthguards should, or should not, be used.
Provision/delivery of a custom mouthguard does not imply directly, or indirectly, any patient doctor relationship between the recipient and White Orthodontics, the corporation, agents or employees.