Home Insemination Waiver


Today's Date: November 17, 2022

Waiver for At-Home Insemination

Background:

At-home insemination means placing semen or sperm in the vagina by a method other than having sex, usually without the help of a healthcare provider. It is always recommended that you use a medical professional for all inseminations.

 

CLIENT ACKNOWLEDGES NEITHER CRYOBANK AMERICA NOR THE LABORATORY NOR ANY OF THEIR RESPECTIVE CURRENT AND/OR FORMER OFFICERS, DIRECTORS, SHAREHOLDERS, EMPLOYEES, CONSULTANTS, ATTORNYES, INSURERS, AGENTS, REPRESENTATIVES, VENDORS, AND SUCCESORS HAVE MADE ANY REPRSENTATIONS, GUARANTEES OR WARRANTIES, EXPRESS OR IMPLIED, TO YOU OF ANY TYPE OR NATURE. ALL CA PRODUCTS AND SERVICES INCLUDING, WITHOUT LIMITATION, THE COLLECTION, PROCESSING, TESTING, FREEZING, STORAGE, SHIPPING, AND THAWING OF SEMEN SPECIMENS, ARE PROVIDED “AS IS” WITH NO REPRESENTATIONS OR WARRANTIES OF ANY KIND, EITHER EXPRESS OR IMPLIED, INCLUDING (BUT NOT LIMITED TO) THE IMPLIED WARRANTIES OF MERCHANTABILITY AND/OR FITNESS FOR A PARTICULAR PURPOSE HEREUNDER, AND NONINFRINGEMENT.

 WITHOUT LIMITING THE GENERALITY OF THE FOREGOING, THERE HAVE BEEN NO REPRESENTATIONS, WARRANTIES OR GUARANTEES WITH RESPECT TO: (1) SUITABILITY OF SEMEN FOR FUTURE INSEMINATIONS OR PREGNANCIES; (2) ANY ADVANTAGE(S) OF USING SEMEN THAT HAS BEEN CRYOPRESERVED OVER OTHER CLINICAL MEANS OF INSEMINATION.

RECIPIENT AGREES ANY CLAIM AGAINST CRYOBANK AMERICA OR THE LABORATORY OR THE ASSIGNEE OF EITHER, INCLUDING BUT NOT LIMITED TO ANY CLAIM FOR LOSS, INJURY, DAMAGE, OR DESTRUCTION FOR WHATEVER REASON SHALL BE LIMTIED TO THE TOTAL AMOUNT OF FEES PAID BY THE RECIPIENT TO CRYOBANK AMERICA UNDER THIS AGREEMENT. THE RECIPIENT HEREBY AGREES TO RELEASE CLAIM AGAINST CRYOBANK AMERICA AND ITS CURRENT AND/OR FORMER OFFICERS, DIRECTORS, SHAREHOLDERS, EMPLOYEES, CONSULTANTS, ATTORNEYS, INSURERS, AGENTS, REPRESENTATIVES, VENDORS, AND SUCCESSORS AND ASSIGNS FROM ANY AND ALL OTHER LIABILITY FOR ANY AND ALL LOSS, HARM, DAMAGE OR CLAIM OF ANY KIND ARISING OUT OF OR RELATED IN ANY WAY TO CRYOBANK AMERICA’S ACTS OR OMISSIONS RELATED TO THIS AGREEMENT TO THE EXTENT THAT SUCH LOSS OR DAMAGE EXCEEDS THE AMOUNT THAT THE RECIPIENT HAS PAID TO CRYOBANK AMERICA.

Recipient acknowledges and understands that by signing this Agreement, Recipient is giving up any right that might exist either now or in the future to use or otherwise seek money damages or other relief against Cryobank America for any reason relating to the donor sperm for at-home insemination, with the sole exception of seeking a return of any moneys paid under the Agreement.

Cryobank America does not warrant that specimens are free of genetic defects or diseases. Cryobank America does not represent or warrant that a pregnancy arising out of the use of Semen Specimens with result in the birth of a healthy, viable child and, or that a child born using a Specimen will be free of disease, deformities, and/or mental defects

THE CLIENT ACKNOWLEDGES THAT THIS SPECIMEN THOUGH USED FOR AT-HOME INSEMINATION, WAS AUTHORIZED FOR USE BY A MEDICAL PROFESSIONAL OTHER THAN ONE USED BY CRYOBANK AMERICA AND UNDERSTANDS ALL RISKS ASSOCIATED WITH PERFORMING AT-HOME INSEMINATION.

 

Government Orders

Notwithstanding any other provision in this Agreement, CA may release or destroy and discard any or all Semen Specimens, without Recipient and/or Directed Donor’s permission, or refrain from doing so despite receiving an Authorization, in each case if ordered to do so by any court of law or governmental body or agency of competent jurisdiction or upon the issuance of any law, regulation, or advisory opinion requiring, in Cryobank America’s opinion, the release or destruction and discarding of such Specimens. For purposes of this Agreement, “Regulation” includes but is not limited to, the requirements of any federal and state permits and/or licenses, held or required to be held by CA and “agency of competent jurisdiction” includes any authority using any such permit or license.

 

Limitations of Liability

Recipient has been counseled and acknowledges that there are inherent risks in the collection, testing, processing, freezing, storage, shipping, thawing, and use of semen, including without limitation, reduced capacity for fertilization and reduced life span of the sperm after thawing, and that Recipient expressly agrees to assume this risk. The parties acknowledge and agree that Cryobank America shall have no liability to the Recipient, or Recipients’ heirs, estate, legal representatives, or any person claiming through any of them, whether in contract or in tort under any other legal theory, for any damages, costs, or expenses, including without limitation, any indirect, special, incidental, consequential, or similar damages, arising out of or in connection with this Agreement or Cryobank America’s performance or nonperformance of its obligations hereunder, even if Cryobank America has been advised of the possibility of such claim. In the event of loss, damage, or destruction of the Semen Specimens for any reason whatsoever, Recipient’s actual damages as a result thereof would be impracticable, or extremely difficult to determine. Accordingly, the Parties hereto agree that in the event of Specimens or any part thereof, are lost, damaged, and/or destroyed for any reason, Recipient shall be entitled to liquidated damages in the amount equal to the storage fee paid by Recipient for the most recent storage year.

 

Indemnification

Recipient agrees to indemnify and hold harmless Cryobank America and its affiliates, and each of their current and former officers, directors, shareholders, employees, consultants, attorneys, insurers, agents, customers, and representatives, and assign from and against any claim, loss, damages, liabilities, demands, offsets, causes of action, and expenses, including attorneys’ and experts’ fees, arising out of or related to any third party action, proceeding or dispute of any nature or kind involving CA products (including Semen Specimens that are subject of this Agreement), ownership, storage, services, use, and/or disposition of the Specimens. Furthermore, Recipient releases Cryobank America from all liability now or hereafter arising out of or related to physical appearance of or any abnormalities, birth defects, hereditary characteristics, or tendencies of any offspring, or form any other adverse consequences, including the transmission of infections, or genetic disease, which may arise in connection with or as a result of using any specimens.

 

Arbitration

Any dispute, controversy, or claim arising out of this Agreement or the performance, breach, or termination thereof relating in any way to products or services obtained from CA shall be submitted and settled by confidential binding arbitration in Dallas, Texas. Arbitration under this Agreement shall be conducted pursuant to the rules established by the American Arbitration Association, by a neutral arbitrator appointed by the American Arbitration Association. Judgement upon the award rendered may be entered in any court having jurisdiction, and prevailing party in the arbitration shall be entitled to recover all costs for the arbitration, including, without limitation, attorneys’ and experts’ fees. All information resulting from or otherwise pertaining to any dispute shall be non-public and handled by Cryobank America, Recipient, and their respective agents in such a way as to prevent the public disclosure of such information. Notwithstanding the foregoing, CA and Recipient shall have the right to seek and obtain court ordered specific performance, injunctive, and other equitable remedies in connection with any actual or threatened breach of this Agreement by Cryobank America or Recipient. Also, if any action or proceeding is brought to enforce or interpret any of the provisions of this Agreement, the prevailing party shall be entitled to recover its reasonable attorneys’ fees and other reasonable costs expended in such an action or proceeding.

 

Force Majeure

Cryobank America shall not be liable to any person for any failure to perform any obligation hereunder to the extent that such failure is due to fire, flood, earthquake, tornado, act of war or terrorism, interruption of public utilities or methods of transportation, compliance with governmental requests, laws, regulations, order or actions, revocation or modification of governmental permits or other required licenses or approvals, accident, inability to produce necessary supplies, riot, act of court or governmental authority, act of God, or other contingencies beyond the reasonable control of CA.

I acknowledge all of the potential risks and have thoroughly read the above, and some information that may not be present in this contract and wish to continue with at-home insemination.

 

 

Additional Provisions:

(a) If any provision or Subject of this Agreement is found to be invalid or unenforceable by any court, that provision shall be ineffective only to the extent that it is in contravention of applicable laws without invalidating the remaining provisions hereof, unless such invalidity and unenforceability would defeat the essential purpose of this Agreement.

(b) The headings and captions contained herein are for convenience only and shall not control or affect the meaning or construction of any provision. Any reference in this Agreement to the freezing of any Semen Specimen and/or Sample shall not apply to, and CA shall have no obligation with respect to the freezing of, any Semen Specimen, Specimen, and/or Sample that has been frozen by a third party before delivery to CA.

(c) Recipient acknowledges receipt of at-home insemination waiver and understand all risks associated with performing an at-home insemination.

(d) This Agreement shall be binding upon and inure to my benefit and the benefit of my heirs, legal representatives, and estate, and to the benefit of CA, its successors and assigns. I may not assign my rights or duties under this Agreement without prior written consent of CA.

(e) Any notices to be provided to a party hereunder shall be sent to the address set forth beneath the Recipients’ signature or such other address as the Recipient may request in writing be used for that purpose. The Recipient (or surviving spouse, or properly-identified intimate partner, shall ensure Cryobank America is kept informed in writing at all times during the term of the agreement of any change in address, including current mailing address, email address(es), and telephone number(s). Recipient shall advise CA promptly in writing on each change of address, or prolonged absence from the last address on file. Recipient acknowledges that his current contact information and records shall be retained by CA for a period of at least seven (7) years after the release of Semen Specimens for artificial inseminations or assisted reproductive procedures not resulting in a live birth, and twenty-five (25) years for inseminations known to have resulted in a live birth.

(f) In the event that CA rejects this Agreement, it will notify Recipient of the rejection. Recipient understands and acknowledges that CA will retain any fees, excluding prepaid Donor Semen Specimens and prepaid shipping costs, which Recipient has paid to CA prior to any such rejection and Recipient shall refrain from any claims against CA arising out of or in connection with a rejection.

(h) This Agreement establishes the entire agreement among Cryobank America and Recipient, related to the subject matter contained herein, and fully supersedes all prior or contemporaneous understandings of the Parties. This Agreement may not be modified or amended without prior written consent of the Parties. This Agreement shall be construed and controlled by the laws of the State of Texas and the parties consent to the exclusive jurisdiction and venue in the courts sitting in Tarrant County, Texas.

I understand all risks involved in at-home insemination and hold harmless Cryobank America and all affiliates

Recipient acknowledges that Recipient had an opportunity to consult with medical advisors and legal counsel of Recipients’ choosing. By providing a signature below, Recipient expressly agrees that her failure to comply with the terms of this Agreement will constitute termination of this Agreement and shall result in the abandonment of said Semen Specimen(s) to Cryobank America. 

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Signed by Sanjay Kumar
Signed On: October 25, 2022


Signature Certificate
Document name: Home Insemination Waiver
lock iconUnique Document ID: 0bcbc52ac792ab2ace48a32bd0f3a9214baed794
Timestamp Audit
TimestampAugust 11, 2022 4:18 pm CSTAuditHome Insemination Waiver Uploaded by Sanjay Kumar - [email protected] IP 2601:285:c800:48f0:a184:4c7a:9a50:c2ab