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(a) Indemnification of Expenses and Other Liabilities. Sample Indemnity Agreement.The terms in your document will update based on the information you provide. I give permission to Releasees to obtain on my behalf any emergency medical treatment. Looking for an indemnification agreement template to use for your business? We've got a template ready to be customized for your needs today. Looking for an indemnification agreement template to use for your business? We've got a template ready to be customized for your needs today. This indemnity agreement template is available for use on UpCounsel. An indemnity agreement sample distributes risk and expense when either party has committed Breach of Contract, Default or Misconduct.