Thank you for registering for the above Event: Surgery Partners 2025 Leadership Conference. Because this event may include activities at multiple locations, various forms of transportation and/or photographs and videos being taken of attendees, it is necessary that all participants understand and agree to the following as a condition of participating. Please review the following carefully and sign at the bottom to indicate your understanding and agreement.
I acknowledge that I am at least eighteen (18) years of age and that I understand the terms of this Agreement. I also acknowledge that this Agreement shall bind my heirs and personal representatives.
WAIVER OF LAWSUIT/LIABILITY
To the maximum extent permitted by law, in consideration for Surgery Partners allowing me to participate in Events affiliated with Surgery Partners, I, on behalf of myself, my heirs, personal representatives, executors, and assigns HEREBY FOREVER RELEASE AND HOLD HARMLESS and waive my right to bring suit against Surgery Partners and any parent company or affiliate or representative thereof, which includes Surgery Partners and its parent company’s or affiliates’ boards of trustees, officers, employees, volunteers, agents, or assigns acting on behalf of such entities, and other representatives (collectively, the “SURGERY PARTNERS RELEASEES”) in connection with entering related host hotels and/or venues and/or participating in any Event. I understand that this Waiver and Assumption of Risk means that, to the maximum extent permitted by law, I, on behalf of myself, my heirs, personal representatives, executors, and assigns, give up and hereby forever waive any and all right to bring any claims, complaints, demands or lawsuits including for personal injuries, death, disease or property losses, or any other loss, and further hereby forever waive any potential claims, right to file a lawsuit, or to seek damages of any kind, whether known or unknown, foreseen or unforeseen, whether arising from the negligence of the SURGERY PARTNERS RELEASEES or otherwise, against any SURGERY PARTNERS RELEASEES.
ASSUMPTION OF RISK
The safety of Event attendees, employees, vendors, guests and hosts are a top priority for Surgery Partners and EES Agency (EES). However, as a condition of entering host hotels and/or venues, or participating in any sponsored, hosted, related, or affiliated event or activity (an “Event”), you knowingly and freely assume all risks, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE SURGERY PARTNERS RELEASEES or others, and assume full responsibility for your participation, on behalf of yourself, and you waive any liability against Surgery Partners and EES for claims that may arise in connection with presence, participation, and/or transportation to/from the Event and its activities.
I understand and acknowledge that Surgery Partners and EES are not insurers of my behavior, actions or participation in the EVENT and assume no liability whatsoever for personal injuries or property damages to me or to third persons arising out of my participation in the Event and its activities.
ASSUMPTION OF RISK: I have read and understand the above warning. I, on behalf of myself, choose to knowingly and freely accept all risks, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE SURGERY PARTNERS RELEASEES or others, in order to visit or enter host hotels and/or venues and/or to participate in Events. These Events are of such value to me that I, on behalf of myself, my heirs, personal representatives, executors, and assigns, accept the risk in order to visit or enter these properties and/or to participate in an Event (including related transportation).
HEALTH CARE: I carry current medical insurance and will bring a valid insurance identification card to the Event(s). I have determined that this insurance is adequate to cover injuries or illnesses that I may sustain while participating in the Event(s). I will be solely responsible for payment in full of all costs of medical care I may receive.
I authorize Surgery Partners and EES to obtain appropriate health care for me in the event that I need it but am unable to obtain it for myself. I also understand and agree that if I experience serious health problems, suffer an injury, or am otherwise in a situation that raises significant health and safety concerns, then Surgery Partners or EES may contact any person whose name I have provided as my “emergency contact.” In the event I require first-aid treatment or other medical services rendered in connection with an emergency or otherwise, I specifically authorize Surgery Partners and/or EES and their directors, officers, employees, volunteers, and agents to call 911 or other emergency services on my behalf. By administering first aid when required or requested, Surgery Partners and EES in no way warrant or assume any liability in relation to the administration of such basic first aid. I further understand that, in the case of emergency, Surgery Partners and/or EES assumes no responsibility or obligation relative to any cost of expense related to carry out an emergency procedure and/or emergency transportation for me and I agree to pay for such costs and expenses and shall indemnify and reimburse Surgery Partners and/or EES for any such costs or expenses that either may incur.
PHOTO & VIDEO RELEASE
I understand that Surgery Partners and/or EES may desire to film, record, and photograph the Events and may, in doing so, capture my image or likeness. I agree to the terms of this Photo and Video Release in connection with any such photography or recording.
IMAGE AND LIKENESS: I hereby grant to Surgery Partners and EES, including their agents, assigns, and licensees, on my own behalf, the right to film, videotape and/or sound record, and photograph me in connection with any Event, and to use my name, photo, film, image and/or likeness captured in any photograph(s), sound recording(s), and/or video(s) taken in connection with an Event (the “Media”). I assign to Surgery Partners and EES, including their agents, assigns, and licensees, all rights of any nature that I may have in the Media, and grant to Surgery Partners and EES a perpetual and irrevocable license to use the Media in any manner, including but not limited to, reproduction, sale, exhibition, copying, broadcast, and distribution of the Media or any program incorporating the Media deemed appropriate and understand that the Media may be edited or combined with other images, sound, text, or information. I further waive any rights that I may have to inspect or approve the Media. Surgery Partners and/or EES are in no way obligated to use the Media and neither Surgery Partners nor EES will owe any monetary or other compensation or attribution to me in connection with the Media. I expressly disclaim all rights to all values and benefits Surgery Partners and/or EES may gain through use of the Media.
RELEASE AND INDEMNIFICATION: To the maximum extent permitted by law, in consideration for Surgery Partners allowing me to participate in an Event, on my own behalf, I hereby release, indemnify, and hold harmless the Surgery Partners Releasees and their successors and assigns from and against any and all claims, actions, demands, lawsuits, liabilities, costs, judgments, losses, expenses, and/or damages (including, without limitation, reasonable attorneys’ fees and court costs) that I or my respective heirs, personal representatives, executors, or assigns may have or claim to have at any time related in any way to the filming or recordation of an Event, the Media (including the image and likeness of myself captured therein) or Surgery Partners’ use of the Media, or that otherwise arise from the Media, or Surgery Partners’ use, distribution, or other exploitation thereof. In the event any such complaint or claim is made by any third party at any time, whether by formal legal complaint or otherwise, I agree to fully cooperate with Surgery Partners in responding to and defending against any such complaint or claim. This Release shall inure to the benefit of Surgery Partners, its parent and sister companies, and their respective successors and assigns, and shall be binding upon me, and my respective heirs, personal representatives, executors, and assigns.
INFORMATION RELEASE
Surgery Partners asks for the above information in relation to their Surgery Partners 2025 Leadership Conference. All medical information will be held in confidence and will only be disclosed if a medical emergency occurs. The remaining information will be used for logistics purposes and will be passed along to third parties involved in those logistics (i.e., EES for rooming list and dietary restrictions for the host hotel and any activity that involves meals, who may also use it — in accordance with their privacy policies — for their own purposes pursuant to the services they offer). By signing below, you are directing us to share this information with them for those purposes.
I consent for Surgery Partners to share personal information about me with third parties involved in this conference.
BY SIGNING THIS WAIVER AND RELEASE, WHICH I DO ON MY OWN BEHALF, I REPRESENT, WARRANT, AND ATTEST THAT (A) I HAVE READ, UNDERSTAND, AND AGREE TO THE ENTIRETY OF THE TERMS OF THIS WAIVER AND RELEASE; (B) I UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT; AND (C) I AM COMPETENT TO UNDERSTAND AND EXECUTE THIS WAIVER AND RELEASE, AND DO SO FREELY, KNOWINGLY, AND VOLUNTARILY. I AGREE THAT I SHALL BE BOUND BY ALL THE TERMS AND CONDITIONS OF THIS WAIVER AND RELEASE, AND I ACKNOWLEDGE AND AGREE THAT THIS WAIVER AND RELEASE IS NOT REVOCABLE.