I/We, the undersigned, are the parent(s) or legal guardian(s) of "the individual"
In consideration of Family First Developmental Disability Solutions LLC referral of a Personal Support Worker for the individual, the undersigned acknowledges, understands and agrees:
1. To waive any and all claims that I/We have or may in the future have against FFamily First Developmental Disability Solutions LLC, and to FFamily First Developmental Disability Solutions LLC, its officers, trustees, agents, and employees, from any and all liability for any loss, damage, expense or injury, including death, due to any cause whatsoever, including negligence, breach of contract, or breach of any statuatory or other duty of care on the part of Family First Developmental Disability Solutions LLC;
2. To hold harmless and indemnify Family First Developmental Disability Solutions LLC, from any and all liability for any property damage, loss or personal injury to any third party;
3. This Agreement shall be effective and binding upon my heirs, next of kin, executors, administrators, assigns and representatives;
4. This Agreement and any rights, duties and obligations as between the parties to this Agreement shall be governed by and interpreted solely in accordance with the laws of state of Maine and no other jurisdiction; and
5. Any litigation involving the parties to this Agreement shall be brought solely within the state of Maine and shall be within the exclusive jurisdiction of the Courts of the state of Maine.
I have read and understood this agreement, and I am aware that by signing this agreement I am waiving certain rights which I or my heirs, next of kin, executors, administrators and assigns may have against Family First Developmental Disability Solutions LLC.
Heirs, next of kin, executors, administrators and assgns may have against Family First Developmental Disability Solutions LLC,