This Limited Evaluation Registration Form, upon completion, constitutes a legally binding agreement for the limited use of the AIRS Evaluation Product (as defined below) provided by AIRS Medical Inc. (“AIRS”) to the customer identified below (“Customer”).

The purpose of this Limited Evaluation Agreement is to provide Customer with access to the AIRS Evaluation Product for the length of time reasonably necessary under the circumstances to assess its appropriate use and functionality. While the license to the AIRS Evaluation Product is provided at no cost during the evaluation period, certain implementation activities necessary to facilitate this evaluation may incur fees. These fees will be clearly communicated to the Customer in advance.