In consideration of you permitting me usage of a wheelchair at Coquitlam Centre, I hereby for myself, my heirs, executors, and administrators and assigns, assume all risks arising from my participation and I waive and release any and all right or claim I may have against Coquitlam Centre, Morguard Corporation, Morguard Investments Limited, or Pensionfund Realty Limited, including all directors, officers, agents and employees acting on behalf, from and against every demand, claim, cause of action, judgment, and expense, and all loss or injury or both that I now have or may have hereafter incur arising from or relating to any action or injury which may occur as a result of, or associated with, using this wheelchair. I understand that although every reasonable precaution is taken to ensure wheelchairs are thoroughly cleaned after each use, there is no guarantee that they are 100 percent free of any given allergens or pathogens. I also warrant that any damage to, or loss of, this wheelchair is my full responsibility. I hereby further warrant that I am of full age and have every right to contract in my own name in this regard.

I have fully informed myself of the contents of this waiver and release by reading it before having signed it.

As agent for the owner of Coquitlam Centre, Morguard Investments Limited (“Morguard”) is committed to maintaining the security and confidentiality of personal information in accordance with applicable privacy legislation and our Privacy Policy. By completing and signing this form, you are consenting to Morguard collecting, using and disclosing your personal information in order to identify and communicate with you, for such other purposes as may be necessary in order to provide you with the products and/or services you have requested, and for any other purposes where you consent or where such collection, use or disclosure is permitted or required by law. You represent that you have all necessary authority and/or have obtained all necessary consents from any other individuals about whom you have disclosed personal information to Morguard in order to enable us to collect, use and disclose such personal information to fulfill the purposes described above. For further information regarding Morguard’s personal information handling practices, please refer to Morguard’s Privacy Policy at www.morguard.com.