I, the undersigned, hereby elect to accept the invitation to participate in the VUMI® annual Convention to be held in San Juan, Puerto Rico from October 25 to October 28, 2021, under the auspices of VIP Universal Medical Insurance Group, Ltd., and its affiliates companies (hereafter “VUMI®”). I understand such travel may be hazardous and I am fully aware of the risks involved and hazards connected to this activity, including but not limited to travel risks, the risk of injury, airborne sickness and possibly death, as well as damage to property, when traveling to and from and/or within this international destination. I understand I may need to travel in areas where there is risk of virus outbreak, violence from crime, terrorism, political unrest and other dangers, and may be exposed to food, water and air- borne diseases, and to disease from other carriers or while traveling internationally. I understand some diseases may not produce symptoms during the actual trip, but may occur after the trip. I understand also medical facilities abroad may not be of the quality of medical facilities in the United States or where I live. I understand VUMI® is strongly recommending to acquire travel insurance to cover any incident I may be involved in during the trip. I understand there may be delays and sudden changes of schedules and/or cancellation of schedules. While reasonable care will be taken in selecting transportation, I understand breakdowns and delays may occur. I understand circumstances may arise such that I might be asked not to go on this trip or to return early, and that no money will be refunded to me. I acknowledge I am in good health and good physical condition. I understand also the journey may involve strenuous physical activity, including, but not limited to, long walks and hiking in hills and or/mountainous areas or any other activities planned for the event. I also understand my participation in any event organized by VUMI® is strictly voluntary. I understand and acknowledge that while VUMI’s providers may take reasonable steps to ensure my safety during travel and while participating in VUMI’s convention activities while abroad, these precautions are merely made in good faith and do not warrant acceptance of liability, nor guarantee that actions undertaken will demonstrate and/or constitute non-negligent performance therein by the organization, its agents or assignees. I am aware that I should review my personal insurance portfolio, especially the travel, accident, and medical coverages. I voluntarily and personally assume the risk of any and all consequences of my travel with VUMI® and for services received from their third party providers, like hotel accommodations, sightseeing tours, activities, transfers, luggage handling, entertainment, transportation (ground and air), tour operators, etc., selected by VUMI® to provide travel and entertainment during the days of the event. It is my express intent that this Waiver of Liability and Hold Harmless Agreement shall bind the members of my family and spouse, if I am alive, and my heirs, assigns and personal representative, if I am deceased, and shall be deemed as a RELEASE, WAIVER, DISCHARGE AND COVENANT NOT TO SUE VUMI®, its officers, personnel or volunteers, its officers, hereafter the “RELEASEES”, resulting from any cause whatsoever, including but not limited to sickness, including but not limited to the inherent risk of exposure to COVID-19 or any other airborne virus that exists in any public place where people are present, personal injury, property damage, delay, change of schedule, wrongful death, theft or loss of property. I further hereby AGREE TO INDEMNIFY AND HOLD HARMLESS the RELEASEES from any loss, liability, damage or costs, including court costs and attorney fees, that they may incur due to my participation in this activity, WHETHER CAUSED BY NEGLIGENCE OF RELEASEES or otherwise. I hereby further agree this Waiver of Liability and Hold Harmless agreement shall be construed in accordance with the laws of the State of Texas, United States of America. In the event any term or provision of this WAIVER OF LIABILITY is found to be unenforceable or void, in whole or in part, then the offending term shall be construed as valid and enforceable to the maximum extent permitted by law, and the balance with this WAIVER OF LIABILITY shall remain in full force and effect. TERMS AND CONDITIONS: I understand VUMI® has the right to approve or reject the attendance of qualified agents and / or their guests at the Convention, at any time or cancel their participation because of any misbehavior or refusing to cooperate with all the prevention measures, health guidelines issued by CDC, WHO or any health authority I have to comply with during the trip and the events. All participants (both agents and their guests) must be over 18 years old. Participants may not bring guests under the age of 18 to any programmed events, even if they offer to pay for the guest’s expenses. This event is by invitation only and is not transferable. PHOTO RELEASE: I hereby grant permission to VIP Universal Medical Insurance Group, Ltd. and its affiliated companies (thereinafter VUMI®) and, its agents, or employees to use any and all photographs taken of me, with or without using my name and affiliation, resulting from my participation in the “Tokyo Convention”. I understand and acknowledge the photographs or videos may be used in VUMI® publications, both printed and electronic, and may be published in any manner, including advertising media, periodicals, gift cards, calendars, postcards, Web site, or as deemed appropriate by VUMI®. I hereby waive any right to inspect or approve the finished photographs or printed or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive the right to any royalties or other compensation arising from, or related to, the use of the photograph or video material. I hereby agree to release, defend, and hold harmless VUMI®, its officers, directors, agents, or employees. including any firm publishing and/or distributing the finished product in whole or on part, whether on paper or electronic media, from and against any claims, damages, or liability arising from or related to the use of the photographs, including but not limited to any misuse, distortion, blurring, alteration, optical illusion or use in composite form, either intentionally or otherwise that may occur or be produced in taking, processing, reduction, or production of the finished product, its publication or distribution. It is the discretion of VUMI® to decide whether to use any images. I am 18 years of age or older and I am competent to contract in my own name. I have read this release before signing below, and I fully understand the contents, meaning, and impact of this release. I understand I am free to address any specific questions regarding this release by submitting those questions in writing prior to signing, and I agree my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release. I understand and acknowledge that this release shall have no expiration date. I, the undersigned, have voluntarily and without duress signed this WAIVER OF LIABILITY form. I assert I have read and fully understand the above WAIVER OF LIABILITY, and that I agree to accept the terms of this WAIVER OF LIABILITY in full. No oral representations, statements, or inducements, apart from the foregoing written agreement, have been made. and I execute this Release for full, adequate and complete consideration fully intending to be bound by same.