Inova HealthNET ~ Waiver

1.        I understand that the information provided to me through Inova HealthNET is for informational and
educational purposes only, and it is neither intended nor implied to be a substitute for professional medical
advice. I understand that I should seek the advice of my physician with any questions I may have regarding
any personal medical condition. I assume any and all risks associated with participating in Inova HealthNET
with or without prior consultation with my physician.

2.        I understand that I may discontinue participation in an Inova HealthNET program at any time.

3.        All information related to my participation in Inova HealthNET will be treated in a strictly confidential
and private manner at all times. Data from all program participants are reviewed, evaluated and reported in
order to monitor and improve program effectiveness. I understand that reports will be constructed so that all
individuals will be protected from any identification or disclosure.

4.        I understand that Inova Health System, by making Inova HealthNET available, is not undertaking any
responsibility regarding my medical condition(s). If my medical condition should change or require medical
attention, I will immediately consult with my physician.

5.        I hereby release and hold harmless Inova Health Systems, their respective directors, trustees, officers,
parents, subsidiaries, affiliates, employees and agents from and against any and all demands, damages,
losses, costs, expenses, obligations, liabilities, claims, actions, and causes of action (whether any of which
is groundless or otherwise) of any nature whatsoever (including, without limitations, reasonable attorney’s
fees and court costs) by reason of or resulting, in any way, from any and all acts, accidents, events,
occurrences, omissions and the like related to, or arising out of , directly or indirectly, my participation in
Inova HealthNET.

6.        Should a provision of this agreement or portion thereof be found invalid or void as against public
policy by any court of competent jurisdiction, the remainder of this agreement shall nonetheless remain in full
force and effect.

7.        I understand that a refund will only be given within seven (7) business days of registering. You will be
refunded the cost of the program minus a $25 processing fee. After 7 business days, no refund will be given.

8.        By checking the box on the registration form, I am acknowledging that I am 18 years of age or older,
and that I understand and accept the terms of this agreement.

Confirmation of acceptance of the Waiver and Release Form, whether via signature or through online
registration is required in order to participate in Inova HealthNET.

Below is the Waiver and Release
that you must agree to
when you sign-up for the program.

Waiver & Release Agreement