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Date: 7/ 21/ 2024

BCGM, Inc. - Account Enrollment

Name:

First M.I. Last

Driver's License #:

Issuing State:

D.O.B:

Phone Number:


Company Name/Account Name:

Address:

Number & Street City State Zip Code

Email:


Referred By:



BCGM, Inc. – Product Purchase Agreement, Liability Release, Waiver, Discharge and Covenant Not to Sue and/or Compete

PLEASE READ AND SIGN THIS DOCUMENT CAREFULLY.

BY SIGNING IT, YOU ARE GIVING UP IMPORTANT LEGAL RIGHTS AND ASSUMING LIABILITY.

1. Authority & Capacity to Enter Agreement: This is a legally binding Product Purchase Agreement, Liability Release, Waiver, Discharge, and Covenant Not to Sue (collectively called hereinafter the “Agreement”), made voluntarily by First Name: ________________ Last Name: ________________ (Purchaser's Name or Entity, hereinafter the "Purchaser"), who is of lawful age and has no mental disability and is acting voluntarily with full authority to enter into the Agreement.

2. Lawful Use: The Purchaser has authority and does voluntarily enter this agreement, to buy the Dangerous Product(s) (Carbon Dioxide, Nitrogen, Nitrous Oxide, Oxygen, or other Compressed Gasses and Cryogenic Liquids, Poisonous, Corrosive, or otherwise harmful Mixtures or other Products or Equipment that could be hazardous) and expressly represents the Purchaser will only use, store, transport, and/or possess said purchased product(s) only for a lawful and safe purpose.

3. Knowledge of Risk of Purchased Products: The Purchaser fully recognizes that there are inherent risks involved in the handling, use, storage, and/or transportation of the Dangerous Product(s), listed above, (hereinafter the "purchased product(s)"), which risks include but are not limited to, that the purchased product(s) are poisonous, toxic, cryogenic, flammable, explosive, and/or corrosive. The Purchaser understands that any of the purchased dangerous product(s) can cause life-threatening injuries, including rapid suffocation without any sensation or prior warning, severe burns, severe frostbite, loss of limb and/or loss of life, and that the purchased product(s) may cause anesthetic or poisonous effects resulting in death. The Purchaser acknowledges:

a. That protective clothing and/or equipment is needed to avoid contact with eyes, skin, or clothing;

b. That the transport, storing, and use of the purchased product(s) must be done in a well-ventilated, secured space and manner;

c. That purchased product(s) must be kept away from combustible and/or flammable materials;

d. That purchased product(s) should be kept away from away heat, flames, or sparks.

e. That in the event of physical injury from the purchased product(s), medical attention should be immediately sought, and the exact purchased product(s) should be immediately disclosed.

4. Release, Waiver, Discharge and Covenant Not to Sue: With fully informed consent and for valuable consideration received, the Purchaser assumes and takes all of the risks and responsibilities, known or unknown, in any way arising from or associated with the possession, storage, use, and/or transportation of the purchased product(s) from the Seller, and hereby releases the Seller and all of its affiliates, divisions, departments and other units, officers, directors, principals, trustees, legal representatives, members, owners, employees, agents, administrators, assigns, and contractors from any and all claims, demands, suits, judgments, damages, actions and liabilities of every name and nature whatsoever, whenever occurring, whether known or unknown, contingent or fixed, at law or in equity, that the Purchaser may suffer at any time arising from or in connection with the purchased product(s), including any injury or harm resulting from this purchase, including but not limited to death, or damage to property, and the Purchaser undersigned below agrees to defend, indemnify, and hold the Seller and all of its affiliates, divisions, departments and other units, officers, directors, principals, trustees, legal representatives, members, owners, employees, agents, administrators, assigns, and contractors harmless from and against any and all liabilities. The Purchaser voluntarily assumes all risk of personal injury or death sustained during the possession, storage, use, and/or transportation of the purchased product(s) from the Seller. It is recognized that the Purchaser is giving up, among other things, all rights to sue the Seller and all of its affiliates, divisions, departments and other units, officers, directors, principals, trustees, legal representatives, members, owners, employees, agents, administrators, assigns, and contractors for injuries, damages or losses that may incur from the purchased product(s) possession, storage, use, or transportation of the purchased product(s) and that this agreement binds the Purchaser's heirs, executors, administrators, legal representatives, agents, and assigns.

5. Covenant Not to Compete: Throughout the duration of this agreement the Purchaser shall not, in any manner, represent, provide services or engage in any aspects of business that would be deemed similar in nature to the business of BCGM, Inc. without the written consent of BCGM, Inc. The Purchaser warrants and guarantees that throughout the duration of this agreement, and for a period not to exceed TWO (2) years following the culmination, completion or termination of this agreement, that the Purchaser shall not directly or indirectly engage in any business that would be considered similar in nature to BCGM, Inc., its subsidiaries, and any current or former clients and/or customers within a One Hundred (100) mile radius of Chicago, Il. Nor shall the Purchaser solicit and client, customer, officer, staff or employee for the benefit of the Purchaser or a third party that is, or may be engaged in, similar business.

6. Choice of Law & Understanding: The Purchaser agrees that this agreement shall be governed for all purposes by the laws of the State of New York, and the Purchaser has read this entire agreement and fully understands the entire agreement and acknowledges that the Purchaser has the opportunity to review this agreement with an attorney of the purchaser's choice and agrees to be legally bound by the agreement.


Signature: DIGITAL SIGNATURE: NAME Date: 7/ 21/ 2024



CGM, Inc. NITROUS OXIDE INTENDED USE FORM

Name:

________________ ________________ ________________
First M.I. Last

Driver's License #:

Issuing State:

________________ ________________

D.O.B:

Phone Number:

________________ ________________

Company Name/Account Name:

________________

Address:

________________ ________________ ________________ ________________
Number & Street City State Zip Code

INTENDED USE OF NITROUS OXIDE:

Whip Cream





I understand that nitrous oxide is a dangerous gas and is not to be inhaled without a medical professional trained in the administration of nitrous oxide and is familiar with dosages, methods, duration and frequency of use. I will not, nor will I allow anyone else to, inhale nitrous oxide without medical supervision.



Signature: DIGITAL SIGNATURE: NAME Date: 7/ 21/ 2024




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