By acknowledging/checking above, the applicant, in consideration of any reimbursement, does hereby voluntarily discharge and release Metropolitan Sewer Subdistrict d/b/a MetroConnects (“MetroConnects”) and its officers, employees, agents from any and all claims, actions, causes of action, losses, demands, rights, damages, costs, loss of service, expenses and compensation whatsoever, which the undersigned now has/have or which may hereafter accrue on account of or in any way growing out of any and all known and unknown, foreseen and unforeseen property damages and any consequences resulting therefrom or to result from the occurrence referenced in this Reimbursement Form (the “Incident”). It is understood and agreed that any reimbursement made to the applicant is not to be construed as an admission of liability or guilt on the part of MetroConnects. MetroConnects specifically denies any liability arising from the Incident. The undersigned further declare(s) and represent(s) that no promise, inducement or agreement not specifically expressed herein has been made to the undersigned, and that this Reimbursement Form contains the entire agreement between the parties hereto, and that the terms of this Reimbursement Form are contractual and binding upon the undersigned applicant.