IABA- ER CARE FLU Vaccine Drive March 4th Saturday- 10am to 5pm  -: Registration Form :-
Event Date: March 4th, SATURDAY
Time: 10am to 5pm


Venue: ER CARE (Open 7 days) Address: 7780 Lake Underhill Rd, Suite 111, Orlando, FL 32822
Contact us at (407) 278-6688 or (407) 974-7501
Email: iabausaoffice@gmail.com

Limited Space Available- REGISTER NOW..!
  • IABA Member- FREE
  • Non-Member- FREE
  • RSVP Only
* Must Book an Appointment/RSVP AND accept Liability Waiver & Terms of this form and on IABA Website

Service provided by ER CARE (Dr. Ajay Patel)

Questions: TEXT: 407-278-6688 - Deadline 29th Feb.
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Email *
Indian American Business Association & Chamber- www.IABAusa.com
ER CARE FLU Vaccine Drive
First & Last Name *
Address (Street, City, State, Zip) *
Cell phone (Example:1234567890) *
Email *
Waiver Agreement-----> I/We, acknowledge that I/We have voluntarily applied to participate in Flu Vaccine Drive Organized by IABA - Indian American Business Association of USA and service provided by ER CARE (Dr. Ajay Patel). I/We are AWARE THAT THESE ACTIVITIES ARE HAZARDOUS AND THAT I/WE COULD BE SERIOUSLY ILL. I/WE AM/ARE VOLUNTARILY PARTICIPATING IN THESE ACTIVITIES WITH KNOWLEDGE OF THE DANGER INVOLVED, AND AGREE TO ASSUME ANY AND ALL RISKS OF BODILY INJURY, DEATH OR PROPERTY DAMAGE, WHETHER THOSE RISKS ARE KNOWN OR UNKNOWN. I/We verify this statement by selecting below checkbox to agree. As consideration for being permitted by the IABA  (Indian American Business Association) and its representatives to participate in these activities and facilities, I/We forever release the IABA Members, Presidents, Executive Committee, Volunteers and Representatives (collectively “Releases”) from any and all actions, claims, or demands that I/we, our assignees, heirs, distributes, guardians, next of kin, spouse and legal representatives now have, or may have in the future, for injury, or property damage, related to (i) my participation in these activities, (ii) the negligence or other acts, whether directly connected to these activities or not, and however caused, by any Releases, or (iii) the condition of the premises where these activities occur, whether or not we are then participating in the activities. I/We also agree that I/We, our assignees, heirs, distributes, guardians, next of kin, spouse and legal representatives will not make a claim against, sue, or attach the property of any Releases in connection with any of the matters covered by the foregoing release. I/WE HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND THE CONTENT. I/WE AM/ARE AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MY SELF AND THE ORGANIZATION, THE STATE, THE COUNTY, AND THE LESSOR, AND SIGN IT OF MY OWN FREE WILL. *
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