From:

Name: _________________________________________________

Position: _______________________________________________

Organization:____________________________________________

Address: _______________________________________________

City: ________________________ State: ____ Zip Code: ________

To:
The Mat King a d/b/a of Geoffrey Drew Marketing, Inc.,
740 West End Avenue;
Suite 1
New York, NY 10025

This is to inform any and all ever to be concerned with regard to the Seclusion Room Protective Padding supplied by The Mat King as per our company's Purchase Order Number: ____________, issued to The Mat King on (month): __________, (date): ______, (year): __________ that all concerned including our company and its leadership and our end-user customer, specifically:

(person or organization) _________________________________

(address) ______________________________________________

(city) ___________________, (state) ______ (Zip Code)__________

are aware that Seclusion Room Protective Padding supplied by The Mat King is intended and is usually supplied with protective wall padding and protective floor matting but that it was decided by our end user client and our company leadership that the protective floor matting is not required or needed for this particular installation and that we and our end user client will take full responsibility for any and all damages that may result in the seclusion room that is to be padded with protective padding supplied by The Mat King. And, further, in the event that an injury should result to an individual or individuals secured for their safety in the seclusion room with protective padding supplied by The Mat King, all responsibility regarding such an injury or injuries will be that of our company and that The Mat King, Geoffrey Drew Marketing, Inc., its leadership, and anyone connected with The Mat King and its partners will be held harmless in every way, and that should the families or injured parties or others on behalf of said injured parties seek compensation based on such injuries from The Mat King et al., that our organization will assume the responsibility, i.e. pay for all legal counsel related fees and any other expenses that may be required or incurred by The Mat King et al.

Signature: ______________________________________

Signed by: ____________________________________

Date: ___________________________________