TransMékong
Mekong-delta.com

The welcoming rice bowl of Vietnam

Export page to Open Document format

Miễn nhiệm - Sử dụng thuốc / Waiver - Use of Medicine

Whereas Cty TNHH Xuyên Mékong and its services, among which those of Mekong-delta.com and the Bassac (here-under: TransMékong) may make some select medicine available free of charge to its passengers and participants to its services

I, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , request the use of medicine from the on-board cabinet, for the use of myself or a member of my party on board (here-under: Our Party).

I am fully aware that:

  • medicine on board is made available as is, without any claim of fitness for any condition;
  • consuming any medicine is non-trivial and presents risks;
  • it is my responsibility to assess which medicine and dosage are appropriate for my or Our Party's condition.

I nevertheless request the use of medicine, and commit to use it only for my or my party's consumption, immediately or within the 12 hours after the end of the services or final disembarkation, whichever comes first.

I hereby:

  • waive any and all claims that I have or may have in the future against TransMékong, its directors, officers, employees, agents, or representatives (here-under: the Releasees);
  • release the Releasees from any and all liability for any loss, damage, injury, expense, or other cost that I may suffer or that my next of kin may suffer in connection with Our Party's use of medicine from the board.
  • declare that I am over 18 years old and responsible for the decision to use medicine for Our Party.
  • declare that this Waiver, Release, and Agreement is fully effective and shall be effective and binding upon me and my heirs, next of kin, executors, administrators, and assigns, or anyone else authorized to act on my behalf or on behalf of my estate.

I have read and understood this document. I am aware that by signing this document, I am waiving certain legal rights that I may have against The Releasees, and I fully agree to do so.

.

.

.
Signed: . . . . . . . . . . . . . . . . Print: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date: . . . . . . . . . .
Date of Birth: . . . . . . . . . . .

Group ID / Name
Date and time Medicine Form & dosage Quantity

.

.

.

.

.

.

.

Last modified: 2024/01/28 18:06 Copyright (c) 2014-2024 TransMékong 144 Hai Bà Trưng, QNK, Cần Thơ - 0903 033 148