I acknowledge that I may experience increased sleepiness during the program. I understand that I should not operate a motor vehicle, machinery or equipment, make important decisions or otherwise conduct activities where alertness is important when in a tired or sleepy state. I know that doing so is hazardous and could lead to loss including injury or death and therefore I will not operate a motor vehicle, machinery or equipment make important decisions or otherwise conduct activities where alertness is important when in a tired or sleepy state. I assume all risks associated with this program, will be solely responsible for any injury, loss or damage that I might sustain while participating in this program and if I am uncertain, I will not commence this program without first consulting my physician.
Having read this waiver and knowing these facts and in consideration of my commencing this program,
(fill in your real name) for myself and anyone entitled to act on my behalf including my heirs, executors, administrators and representatives, hereby waive and release and forever discharge the University of Toronto, The Sleep and Alertness Clinic and its umbrella organizations, its employees, volunteers, independent contractors, officers and director, and their representatives and successors from all claims or liabilities of any kind and for any cause whatsoever arising out of my participation in this Program. I sign this waiver and release, freely, voluntarily and understanding its meaning and significance. I confirm that I am at least 18 years of age.
Please sign below to accept the above conditions, waiver and release. In any event, your use of any module of this program shall be deemed acceptance of the above waiver and release. If you do not agree, do not use any of this program.