Registration Rights Agreement



 EXHIBIT 4.11 
 EXECUTION COPY 
  
  

 
 REGISTRATION RIGHTS AGREEMENT

 Dated as of November 18, 2011 
 Among 
 HEALTH MANAGEMENT ASSOCIATES, INC., 

the Guarantors party hereto 
 and 
 DEUTSCHE BANK SECURITIES INC. 

and 
 WELLS FARGO
SECURITIES, LLC, 
 as Representatives of the Initial Purchasers 

7.375% Senior Notes due 2020 
  

 
  







 TABLE OF CONTENTS 

 

							
	 Page
	  	 	  	 	 
			
	 1.
	  	 Definitions
	  	 	1	  
			
	 2.
	  	 Exchange Offer
	  	 	5	  
			
	 3.
	  	 Shelf Registration
	  	 	9	  
			
	 4.
	  	 Additional Interest
	  	 	10	  
			
	 5.
	  	 Registration Procedures
	  	 	11	  
			
	 6.
	  	 Registration Expenses
	  	 	20	  
			
	 7.
	  	 Indemnification and Contribution
	  	 	21	  
			
	 8.
	  	 Rule 144A
	  	 	25	  
			
	 9.
	  	 Underwritten Registrations
	  	 	26	  
			
	 10.
	  	 Miscellaneous
	  	 	26	  








 REGISTRATION RIGHTS AGREEMENT 

This Registration Rights Agreement (this “Agreement”) is dated as of November 18, 2011, among
HEALTH MANAGEMENT ASSOCIATES, INC., a Delaware corporation (the “Company”), the Guarantors (as defined below) and DEUTSCHE BANK SECURITIES INC. and WELLS FARGO SECURITIES, LLC, as representatives (the
“Representatives”) of the several initial purchasers (the “Initial Purchasers”) named on Schedule 2 to the Purchase Agreement (as defined below). 

This Agreement is entered into in connection with the Purchase Agreement, dated as of November 8, 2011 (the
“Purchase Agreement”), among the Company, the guarantors party thereto and the Representatives, which provides for, among other things, the sale by the Company to the Initial Purchasers of $875,000,000 in aggregate principal amount
of the Company’s 7.375% Senior Notes due 2020 (the “Notes”). The Notes are issued under an indenture, dated as of the date hereof (as amended or supplemented from time to time, the “Indenture”), among the
Company, as issuer, the Guarantors and U.S. Bank, National Association, as Trustee (as defined below). Pursuant to the Indenture, each Guarantor is required to unconditionally guarantee on a senior unsecured basis the Company’s obligations
under the Notes and the Indenture. In order to induce the Representatives to enter into the Purchase Agreement, the Company has agreed to provide the registration rights set forth in this Agreement for the benefit of the Initial Purchasers and,
except as otherwise set forth herein, any subsequent Holder (as defined below) or Holders of the Notes. The execution and delivery of this Agreement on or prior to the Issue Date (as defined below) is a condition to the Initial Purchasers’
obligation to purchase and pay for the Notes under the Purchase Agreement. 
 The parties hereby agree as
follows: 
  

	 	1.	 Definitions 


 As used in this Agreement, the following terms shall have the following meanings: 
 “Additional Interest” has the meaning specified in Section 4(a) hereof. 
 “Advice” has the meaning specified in the last paragraph of Section 5 hereof. 
 “Agreement” has the meaning specified in the first introductory paragraph hereto. 
 “Applicable Period” has the meaning specified in Section 2(b) hereof. 
 “Business Day” has the meaning ascribed to such term in Rule 14d-1 under the Exchange Act. 
 “Company” has the meaning specified in the first introductory paragraph hereto. 







 “Effectiveness Date” means, with respect to any Shelf
Registration Statement, the 120th day after the delivery of a Shelf Notice as required pursuant to Section 2(c) hereof; provided, however, that if the Effectiveness Date would otherwise fall on a day that is not a Business Day,
then the Effectiveness Date shall be the next succeeding Business Day. 
 “Effectiveness
Period” has the meaning specified in Section 3(a) hereof. 
 “Event Date” has
the meaning specified in Section 4(b) hereof. 
 “Exchange Act” means the Securities
Exchange Act of 1934, as amended, and the rules and regulations of the SEC promulgated thereunder. 

“Exchange Offer” has the meaning specified in Section 2(a) hereof. 

“Exchange Offer Registration Statement” has the meaning specified in Section 2(a) hereof.

 “Exchange Notes” has the meaning specified in Section 2(a) hereof. 

“Filing Date” means the 90th day after the delivery of a Shelf Notice as required pursuant to
Section 2(c) hereof; provided, however, that if the Filing Date would otherwise fall on a day that is not a Business Day, then the Filing Date shall be the next succeeding Business Day. 

“FINRA” means Financial Services Regulatory Authority, Inc. 

“Guarantees” means the unconditional guarantees of the Notes, the Exchange Notes and the Private
Exchange Notes on a senior unsecured basis by the Guarantors pursuant to the Indenture or any indenture (if different) governing the Exchange Notes and Private Exchange Notes, as applicable. Unless the context otherwise requires, any reference
herein to a “Note”, an “Exchange Note” or a “Private Exchange Note” shall be deemed to include a reference to the related Guarantees. 

“Guarantors” means each of the guarantors listed on the signature pages to this Agreement and any
additional guarantor that executes a Guarantee after the date of this Agreement, in each case unless and until such Guarantor’s Guarantee is terminated or otherwise released in accordance with the Indenture or any indenture (if different)
governing the Exchange Notes and the Private Exchange Notes, as applicable. 
 “Holder” means
any beneficial holder of Registrable Securities. 
 “Indenture” has the meaning specified in
the second introductory paragraph hereto. 
 “Information” has the meaning specified in
Section 5(n) hereof. 

  
 2 








 “Initial Purchasers” has the meaning specified in the
first introductory paragraph hereto. 
 “Initial Shelf Registration” has the meaning specified
in Section 3(a) hereof. 
 “Inspectors” has the meaning specified in Section 5(n)
hereof. 
 “Issue Date” means November 18, 2011, the date of original issuance of the
Notes. 
 “Notes” has the meaning specified in the second introductory paragraph hereto.

 “Participant” has the meaning specified in Section 7(a) hereof. 

“Participating Broker-Dealer” has the meaning specified in Section 2(b) hereof. 

“Person” means an individual, trustee, corporation, partnership, limited liability company, joint stock
company, trust, unincorporated association, union, business association, firm or other legal entity. 

“Private Exchange” has the meaning specified in Section 2(b) hereof. 

“Private Exchange Notes” has the meaning specified in Section 2(b) hereof. 

“Prospectus” means the prospectus included in any Registration Statement (including, without
limitation, any prospectus subject to completion and a prospectus that includes any information previously omitted from a prospectus filed as part of an effective registration statement in reliance upon Rules 430A or 430C under the Securities
Act), as amended or supplemented by any prospectus supplement, and all other amendments and supplements to the Prospectus, including post-effective amendments, and all material incorporated by reference or deemed to be incorporated by reference in
such Prospectus. 
 “Purchase Agreement” has the meaning specified in the second introductory
paragraph hereto. 
 “Records” has the meaning specified in Section 5(n) hereof.

 “Registrable Securities” means each Note upon its original issuance and at all times
subsequent thereto, each Exchange Note as to which Section 2(c)(iv) hereof is applicable upon original issuance and at all times subsequent thereto and each Private Exchange Note upon original issuance thereof and at all times subsequent
thereto, and, in each case, the related Guarantees, until, in each case, the earliest to occur of (i) a Registration Statement (other than, with respect to any Exchange Notes as to which Section 2(c)(iv) hereof is applicable, the Exchange
Offer Registration Statement) covering such Note, Exchange Note or Private Exchange Note has been declared effective by the SEC and such Note, Exchange Note or Private 

  
 3 








 
Exchange Note, as the case may be, has been disposed of in accordance with such effective Registration Statement, (ii) such Note has been exchanged pursuant to the Exchange Offer for an
Exchange Note or Exchange Notes that may be resold without restriction under state and federal securities laws, (iii) such Note, Exchange Note or Private Exchange Note, as the case may be, ceases to be outstanding for purposes of the Indenture
or any indenture (if different) governing the Exchange Notes and Private Exchange Notes, as applicable, or (iv) the date upon which such Note, Exchange Note or Private Exchange Note has been resold in compliance with Rule 144,
provided that such Note, Exchange Note or Private Exchange Note, as the case may be, does not bear any restrictive legend relating to the Securities Act and does not bear a restricted CUSIP number. 

“Registration Statement” means any registration statement of the Company that covers any of the Notes,
the Exchange Notes or the Private Exchange Notes filed with the SEC under the Securities Act, including, in each case, the Prospectus, amendments and supplements to such registration statement, including post-effective amendments, all exhibits, and
all material incorporated by reference or deemed to be incorporated by reference in such registration statement. 
 “Representatives” has the meaning specified in the first introductory paragraph hereto. 
 “Rule 144” means Rule 144 under the Securities Act. 
 “Rule 144A” means Rule 144A under the Securities Act. 
 “Rule 405” means Rule 405 under the Securities Act. 
 “Rule 415” means Rule 415 under the Securities Act. 
 “Rule 424” mean Rule 424 under the Securities Act. 
 “SEC” means the U.S. Securities and Exchange Commission. 
 “Securities Act” means the Securities Act of 1933, as amended, and the rules and regulations of the SEC promulgated thereunder. 

“Shelf Notice” has the meaning specified in Section 2(c) hereof. 

“Shelf Registration” means the Initial Shelf Registration and any Subsequent Shelf Registration.

 “Shelf Registration Statement” means any Registration Statement relating to a Shelf
Registration. 
 “Subsequent Shelf Registration” has the meaning specified in
Section 3(b) hereof. 

  
 4 








 “Shelf Suspension Period” has the meaning specified in
Section 3(a) hereof. 
 “TIA” means the Trust Indenture Act of 1939, as amended.

 “Trustee” means the trustee under the Indenture and the trustee under any indenture (if
different) governing the Exchange Notes and Private Exchange Notes. 
 “Underwritten Offering”
or “Underwritten Registration” means a registration in which securities of the Company are sold to an underwriter for reoffering to the public. 

Except as otherwise specifically provided, all references in this Agreement to acts, laws, statutes, rules, regulations,
releases, forms, no-action letters and other regulatory requirements (collectively, “Regulatory Requirements”) shall be deemed to refer also to any amendments thereto and all subsequent Regulatory Requirements adopted as a
replacement thereto having substantially the same effect therewith; provided that Rule 144 shall not be deemed to amend or replace Rule 144A. 
  

	 	2.	 Exchange Offer 


 (a)    Unless the Exchange Offer would violate applicable law or any applicable interpretation of the staff of the SEC, the Company shall use its reasonable best efforts to file with
the SEC a Registration Statement (the “Exchange Offer Registration Statement”) on an appropriate registration form with respect to a registered offer (the “Exchange Offer”) to exchange any and all of the Registrable
Securities for a like aggregate principal amount of debt securities of the Company (the “Exchange Notes”), unconditionally guaranteed on a senior unsecured basis by the Guarantors, that are identical in all material respects to the
Notes (except that (i) the Exchange Notes shall contain no restrictive legend thereon and (ii) interest thereon shall accrue from the last date on which interest was paid on such Notes or, if no such interest has been paid, from the Issue
Date), which are entitled to the benefits of the Indenture or a trust indenture which is identical in all material respects to the Indenture (other than such changes to the Indenture or any such identical trust indenture as are necessary to comply
with the TIA) and which, in either case, has been qualified under the TIA. The Exchange Offer shall comply with all applicable tender offer rules and regulations under the Exchange Act and other applicable laws. The Company shall use its reasonable
best efforts to (x) prepare and file with the SEC the Exchange Offer Registration Statement with respect to the Exchange Offer, (y) keep the Exchange Offer open for at least 20 Business Days (or longer if required by applicable law) after
the date that notice of the Exchange Offer is mailed to Holders and (z) consummate the Exchange Offer on or prior to the 365th day following the Issue Date. 

Each Holder (including, without limitation, each Participating Broker-Dealer) that participates in the Exchange Offer,
as a condition to participation in the Exchange Offer, will be required to represent to the Company in writing (which may be contained in an applicable letter of transmittal) that: (i) any Exchange Notes acquired in exchange for Registrable
Securities tendered are being acquired in the ordinary course of business of the Person receiving such 

  
 5 








 
Exchange Notes, whether or not such recipient is such Holder itself; (ii) at the time of the commencement or consummation of the Exchange Offer, neither such Holder nor, to the actual
knowledge of such Holder, any other Person receiving Exchange Notes from such Holder, has an arrangement or understanding with any Person to participate in the distribution (within the meaning of the Securities Act) of the Exchange Notes in
violation of the provisions of the Securities Act; (iii) neither the Holder nor, to the actual knowledge of such Holder, any other Person receiving Exchange Notes from such Holder, is an “affiliate” (as defined in Rule 405) of
the Company or, if it is an affiliate of the Company, it will comply with the registration and prospectus delivery requirements of the Securities Act to the extent applicable and will provide information to be included in the Shelf Registration
Statement in accordance with Section 5 hereof in order to have its Notes included in the Shelf Registration Statement and benefit from the provisions regarding Additional Interest in Section 4 hereof; (iv) if such Holder is not a
broker-dealer, neither such Holder nor, to the actual knowledge of such Holder, any other Person receiving Exchange Notes from such Holder, is engaging in or intends to engage in a distribution of the Exchange Notes; and (v) if such Holder is a
Participating Broker-Dealer, such Holder has acquired the Registrable Securities for its own account in exchange for Notes that were acquired as a result of other trading activities and that it will comply with the applicable provisions of the
Securities Act (including, but not limited to, the prospectus delivery requirements thereunder). 
 Upon
consummation of the Exchange Offer in accordance with this Section 2, the provisions of this Agreement shall continue to apply, mutatis mutandis, solely with respect to Registrable Securities that are Private Exchange Notes,
Exchange Notes as to which Section 2(c)(iv) hereof is applicable and Exchange Notes held by Participating Broker-Dealers, and the Company shall have no further obligation to register Registrable Securities (other than Private Exchange Notes and
Exchange Notes as to which Section 2(c)(iv) hereof applies) pursuant to Section 3 hereof. 
 No
securities other than the Exchange Notes and the Notes (and, in each case, the related Guarantees) shall be included in the Exchange Offer Registration Statement. 

(b)    The Company shall include within the Prospectus contained in the Exchange Offer Registration
Statement a section entitled “Plan of Distribution”, which shall contain a summary statement of the positions taken or policies made by the staff of the SEC with respect to the potential “underwriter” status of any broker-dealer
that is the “beneficial owner” (as defined in Rule 13d-3 under the Exchange Act) of Exchange Notes received by such broker-dealer in the Exchange Offer (a “Participating Broker-Dealer”), whether such positions or
policies have been publicly disseminated by the staff of the SEC or such positions or policies represent the prevailing views of the staff of the SEC. Such “Plan of Distribution” section shall also expressly permit, to the extent permitted
by applicable policies and regulations of the SEC, the use of the Prospectus by all Participating Broker-Dealers, and include a statement describing the means by which Participating Broker-Dealers may resell the Exchange Notes in compliance with the
Securities Act. 
 The Company shall use its reasonable best efforts to keep the Exchange Offer


  
 6 








 
Registration Statement effective and to amend and supplement the Prospectus contained therein in order to permit such Prospectus to be lawfully delivered by all Persons subject to the prospectus
delivery requirements of the Securities Act for such period of time as is necessary to comply with applicable law in connection with any resale of the Exchange Notes; provided, however, that such period shall not be required to exceed
180 days or such longer period if extended pursuant to the last paragraph of Section 5 hereof (the “Applicable Period”). 
 If, prior to consummation of the Exchange Offer, the Initial Purchasers hold any Notes acquired by them that have the status of an unsold allotment in the initial distribution, the Company, upon the
request of the Initial Purchasers, shall simultaneously with the delivery of the Exchange Notes issue and deliver to the Initial Purchasers, in exchange (such exchange, the “Private Exchange”) for such Notes held by any such Holder,
a like principal amount of notes (the “Private Exchange Notes”) of the Company, unconditionally guaranteed by the Guarantors on a senior unsecured basis, that are identical in all material respects to the Exchange Notes except for
the placement of a restrictive legend on such Private Exchange Notes. The Private Exchange Notes shall be issued pursuant to the same indenture as the Exchange Notes and bear the same CUSIP number as the Exchange Notes if permitted by the CUSIP
Service Bureau. 
 In connection with the Exchange Offer, the Company shall: 

(1)    mail or deliver, or cause to be mailed or delivered, to each Holder of record
entitled to participate in the Exchange Offer, a copy of the Prospectus forming part of the Exchange Offer Registration Statement, together with any appropriate letter of transmittal and related documents; 

(2)    use its reasonable best efforts to keep the Exchange Offer open for not less
than 20 Business Days from the date that notice of the Exchange Offer is provided to Holders (or longer if required by applicable law); 
 (3)    utilize the services of a depositary for the Exchange Offer with an address in the Borough of Manhattan, the City of New York, which may be the Trustee or an affiliate thereof;

 (4)    permit Holders to withdraw tendered Notes at any time prior to the
close of business, New York time, on the last Business Day on which the Exchange Offer remains open; and 
 (5)    otherwise comply in all material respects with all laws, rules and regulations applicable to the Exchange Offer. 

As soon as practicable after the close of the Exchange Offer and any Private Exchange, the Company shall: 

(1)    accept for exchange all Registrable Securities validly tendered and not


  
 7 








 
validly withdrawn pursuant to the Exchange Offer and any Private Exchange; 
 (2)    deliver to the Trustee for cancellation all Registrable Securities so accepted for exchange; and 

(3)    cause the Trustee to authenticate and deliver promptly to each Holder of
Notes, Exchange Notes or Private Exchange Notes, as the case may be, equal in principal amount to the Notes of such Holder so accepted for exchange; provided that, in the case of any Notes held in global form by a depositary, authentication
and delivery to such depositary of one or more replacement Notes in global form in an equivalent principal amount thereto for the account of such Holders in accordance with the Indenture shall satisfy such authentication and delivery requirement.

 The Exchange Offer and the Private Exchange shall not be subject to any conditions, other than that:
(i) the Exchange Offer or Private Exchange, as the case may be, does not violate applicable law or any applicable interpretation of the staff of the SEC; (ii) no action or proceeding shall have been instituted or threatened in any court or
by any governmental agency which might materially impair the ability of the Company to proceed with the Exchange Offer or the Private Exchange; and (iii) all governmental approvals shall have been obtained, which approvals the Company deems
necessary for the consummation of the Exchange Offer or Private Exchange. 
 The Exchange Notes and the Private
Exchange Notes shall be issued under (i) the Indenture or (ii) an indenture identical in all material respects to the Indenture and which, in either case, has been qualified under the TIA or is exempt from such qualification and shall
provide that the Exchange Notes shall not be subject to the transfer restrictions set forth in the Indenture. The Indenture or such indenture shall provide that the Exchange Notes, the Private Exchange Notes and the Notes shall vote and consent
together on all matters as one class and that none of the Exchange Notes, the Private Exchange Notes or the Notes will have the right to vote or consent as a separate class on any matter. 

(c)    If, (i) because of any change in law or in currently prevailing interpretations of the
staff of the SEC, the Company is not permitted to effect the Exchange Offer, (ii) the Exchange Offer is not consummated within 365 days of the Issue Date, (iii) any Holder of Private Exchange Notes so requests in writing to the Company at
any time within 30 days after the consummation of the Exchange Offer or (iv) (A) any Holder is not permitted by applicable law or SEC policy to participate in the Exchange Offer or (B) in the case of any Holder that participates in
the Exchange Offer, such Holder does not receive Exchange Notes on the date of the exchange that may be sold without restriction under state and federal securities laws (other than due solely to the status of such Holder as an affiliate of the
Company within the meaning of the Securities Act) and, in each case, so notifies the Company within 30 days after such Holder first becomes aware of such restrictions, in the case of each of clauses (i) through (iv) of this sentence, then
the Company shall promptly deliver to the Trustee (to deliver to the Holders) written notice thereof (the “Shelf Notice”) and shall file a Shelf Registration pursuant to 

  
 8 








 
Section 3 hereof. 
  

	 	3.	 Shelf Registration 


 If at any time a Shelf Notice is delivered as contemplated by Section 2(c) hereof, then: 
 (a)    Shelf Registration.    The Company shall promptly file with the SEC a Registration Statement for an offering to be made on a continuous basis pursuant
to Rule 415 covering all of the Registrable Securities (the “Initial Shelf Registration”). The Company shall use its reasonable best efforts to file with the SEC the Initial Shelf Registration on or prior to the Filing Date.
The Initial Shelf Registration shall be on Form S-1 or another appropriate form permitting registration of such Registrable Securities for resale by Holders in the manner or manners designated by them (including, without limitation, one or more
Underwritten Offerings). The Company shall not permit any securities other than the Registrable Securities and the Notes (and, in each case, the related Guarantees) to be included in the Initial Shelf Registration or any Subsequent Shelf
Registration. 
 The Company shall use its reasonable best efforts to cause the Shelf
Registration to be declared effective under the Securities Act on or prior to the Effectiveness Date and to keep the Initial Shelf Registration continuously effective under the Securities Act until the earlier of (i) the date that is two years
from the Issue Date (ii) the date that the Notes cease to be Registerable Securities, and (iii) such shorter period ending when all Registrable Securities covered by the Initial Shelf Registration have been sold in the manner set forth and
as contemplated in the Initial Shelf Registration or, if applicable, a Subsequent Shelf Registration (the “Effectiveness Period”); provided, however, that the Effectiveness Period in respect of the Initial Shelf
Registration shall be extended to the extent required to permit dealers to comply with the applicable prospectus delivery requirements of Rule 174 under the Securities Act and as otherwise provided herein. 

Notwithstanding anything to the contrary in this Agreement, at any time, the Company may delay the filing
of any Initial Shelf Registration Statement or delay or suspend the effectiveness thereof, for a reasonable period of time, but not in excess of 60 consecutive days or more than two times during any calendar year (each, a “Shelf Suspension
Period”), if the Board of Directors of the Company determines reasonably and in good faith that the filing of any such Initial Shelf Registration Statement or the continuing effectiveness thereof would require the disclosure of non-public
material information that, in the reasonable judgment of the Board of Directors of the Company, would be detrimental to the Company if so disclosed or would otherwise materially adversely affect a financing, acquisition, disposition, merger or other
material transaction or such action is required by applicable law. 

(b)    Withdrawal of Stop Orders; Subsequent Shelf
Registrations.    If the Initial 

  
 9 








 
Shelf Registration or any Subsequent Shelf Registration ceases to be effective for any reason at any time during the Effectiveness Period, the Company shall use its reasonable best efforts to
obtain the prompt withdrawal of any order suspending the effectiveness thereof, and in any event shall file an additional Shelf Registration Statement pursuant to Rule 415 covering all of the Registrable Securities covered by and not sold under the
Initial Shelf Registration or an earlier Subsequent Shelf Registration (each, a “Subsequent Shelf Registration”). If a Subsequent Shelf Registration is filed, the Company shall use its reasonable best efforts to cause the Subsequent
Shelf Registration to be declared effective under the Securities Act as soon as practicable after such filing and to keep such subsequent Shelf Registration continuously effective for a period equal to the number of days in the Effectiveness Period
less the aggregate number of days during which the Initial Shelf Registration or any Subsequent Shelf Registration was previously effective. 
 (c)    Supplements and Amendments.    The Company shall promptly supplement and amend the Shelf Registration if required by the rules, regulations or
instructions applicable to the registration form used for such Shelf Registration, if required by the Securities Act, or if reasonably requested by the Holders of a majority in aggregate principal amount of the Registrable Securities (or their
counsel) covered by such Registration Statement with respect to the information included therein with respect to one or more of such Holders, or, if reasonably requested by any underwriter of such Registrable Securities, with respect to the
information included therein with respect to such underwriter. 
  

	 	4.	 Additional Interest 


 (a)    The Company and the Initial Purchasers agree that the Holders will suffer damages if the Company fails to fulfill its obligations under Section 2 or 3 hereof and that it
would not be feasible to ascertain the extent of such damages with precision. Accordingly, the Company agrees to pay as liquidated damages, additional interest on the Notes (“Additional Interest”) if (A) the Company has neither
(i) exchanged Exchange Notes for all Notes validly tendered in accordance with the terms of the Exchange Offer nor (ii) had a Shelf Registration Statement declared effective, in either case on or prior to the 365th day after the Issue
Date, (B) notwithstanding clause (A), the Company is required to file a Shelf Registration Statement and such Shelf Registration Statement is not declared effective on or prior to the later of (I) the 365th day after the Issue Date or (II)
the 120th day after the deliver of a Shelf Notice or (C), if applicable, a Shelf Registration has been declared effective and such Shelf Registration ceases to be effective at any time during the Effectiveness Period (other than because of a
Shelf Suspension Period), then Additional Interest shall accrue on the principal amount of the Notes at a rate of 0.25% per annum (which rate will be increased by an additional 0.25% per annum for each subsequent 90 day period that such
Additional Interest continues to accrue, provided that the rate at which such Additional Interest accrues may in no event exceed 1.00% per annum) (such Additional Interest to be calculated by the Company) commencing on the (x) 366th
day after the Issue Date, in the case of (A) above, (y) the 366th day after the Issue Date or the 121st 

  
 10 









 
day after the delivery of a Shelf Notice, as applicable, in the case of (B) above or (z) the day such Shelf Registration ceases to be effective in the case of (C) above;
provided, however, that upon the exchange of the Exchange Notes for all Notes tendered (in the case of clause (A)(i) of this Section 4), upon the effectiveness of the applicable Shelf Registration Statement (in the case of
(A)(ii) or (B) of this Section 4), or upon the effectiveness of the applicable Shelf Registration Statement which had ceased to remain effective (in the case of (C) of this Section 4), Additional Interest on the Notes in respect
of which such events relate as a result of such clause (or the relevant subclause thereof), as the case may be, shall cease to accrue. Notwithstanding any other provisions of this Section 4, the Company shall not be obligated to pay Additional
Interest provided in Section 4(a)(B) hereof during a Shelf Suspension Period permitted by Section 3(a) hereof and no Additional Interest shall accrue on the Notes following the second anniversary of the Issue Date. 

(b)    The Company shall promptly notify the Trustee within five Business Days after each and every
date on which an event occurs in respect of which Additional Interest is required to be paid (an “Event Date”). Any amounts of Additional Interest due pursuant to (a) this Section 4 will be payable in cash on the dates and
in the manner provided in the Indenture), commencing with the first such date occurring after any such Additional Interest commences to accrue. The amount of Additional Interest will be determined by the Company by multiplying the applicable
Additional Interest rate by the principal amount of the Registrable Securities, multiplied by a fraction, the numerator of which is the number of days such Additional Interest rate was applicable during such period (determined on the basis of a
365 day year comprised of twelve 30 day months and, in the case of a partial month, the actual number of days elapsed), and the denominator of which is 365. 
  

	 	5.	 Registration Procedures 


 In connection with the filing of any Registration Statement pursuant to Section 2 or 3 hereof, the Company shall effect such registrations to permit the sale of the securities covered thereby in
accordance with the intended method or methods of disposition thereof, and pursuant thereto and in connection with any Registration Statement filed by the Company hereunder, the Company shall: 

(a)    Prepare and file with the SEC (prior to the applicable Filing Date in the case
of a Shelf Registration), a Registration Statement or Registration Statements as prescribed by Section 2 or 3 hereof, and use its reasonable best efforts to cause each such Registration Statement to become effective and remain effective as
provided herein; provided, however, that if (1) such filing is pursuant to Section 3 hereof or (2) a Prospectus contained in the Exchange Offer Registration Statement filed pursuant to Section 2 hereof is required
to be delivered under the Securities Act by any Participating Broker-Dealer who seeks to sell Exchange Notes during the Applicable Period relating thereto from whom the Company has received prior written notice that it will be a Participating
Broker-Dealer in the Exchange Offer, before filing any Registration Statement or Prospectus or any amendments or supplements thereto, the Company shall 

  
 11 









 
furnish to and afford counsel for the Holders of the Registrable Securities covered by such Registration Statement (with respect to a Registration Statement filed pursuant to Section 3
hereof) or counsel for such Participating Broker-Dealer (with respect to any such Registration Statement), as the case may be, and counsel to the managing underwriters, if any, an opportunity to review copies of all such documents (including copies
of any documents to be incorporated by reference therein and all exhibits thereto) proposed to be filed (in each case at least three Business Days prior to such filing). The Company shall not file any Registration Statement or Prospectus or any
amendments or supplements thereto if the Holders of a majority in aggregate principal amount of the Registrable Securities covered by such Registration Statement, their counsel, or the managing underwriters, if any, shall reasonably and as promptly
as practical object; provided, that, such objection shall be deemed to be reasonable if such Registration Statement or Prospectus or any amendment or supplement thereto contains an untrue statement of a material fact or omits to state any
material fact necessary to make the statements therein not misleading. 

(b)    Prepare and file with the SEC such amendments and post-effective amendments to
each Shelf Registration Statement or Exchange Offer Registration Statement, as the case may be, as may be necessary to keep such Registration Statement continuously effective for the Effectiveness Period, the Applicable Period or until consummation
of the Exchange Offer, as the case may be; cause the related Prospectus to be supplemented by any Prospectus supplement required by applicable law, and as so supplemented to be filed pursuant to Rule 424; and comply with the provisions of the
Securities Act and the Exchange Act applicable to it with respect to the disposition of all securities covered by such Registration Statement as so amended or in such Prospectus as so supplemented and with respect to the subsequent resale of any
securities being sold by an Participating Broker-Dealer covered by any such Prospectus in all material respects. The Company shall be deemed not to have used its reasonable best efforts to keep a Registration Statement effective if it voluntarily
takes any action that is reasonably expected to result in selling Holders of the Registrable Securities covered thereby or Participating Broker-Dealers seeking to sell Exchange Notes not being able to sell such Registrable Securities or such
Exchange Notes during that period, unless such action is required by applicable law or permitted by this Agreement. 
 (c)    If (1) a Shelf Registration is filed pursuant to Section 3 hereof or (2) a Prospectus contained in the Exchange Offer Registration Statement filed pursuant to
Section 2 hereof is required to be delivered under the Securities Act by any Participating Broker-Dealer who seeks to sell Exchange Notes during the Applicable Period relating thereto from whom the Company has received written notice that it
will be a Participating Broker-Dealer in the Exchange Offer, notify the selling Holders of Registrable Securities (with respect to a Registration Statement filed pursuant to Section 3 hereof), or each such Participating Broker-Dealer (with
respect to any such Registration Statement), as the case may be, their counsel and the managing 

  
 12 









 
underwriters, if any, promptly (but in any event within five Business Days), and confirm such notice in writing, (i) when a Prospectus or any Prospectus supplement or post-effective
amendment has been filed, and, with respect to a Registration Statement or any post-effective amendment, when the same has become effective under the Securities Act (including in such notice a written statement that any Holder may, upon request,
obtain, at the sole expense of the Company, one conformed copy of such Registration Statement or post-effective amendment including financial statements and schedules, documents incorporated or deemed to be incorporated by reference and exhibits),
(ii) of the issuance by the SEC of any stop order suspending the effectiveness of a Registration Statement or of any order preventing or suspending the use of any preliminary prospectus or the initiation of any proceedings for that purpose,
(iii) if at any time when a prospectus is required by the Securities Act to be delivered in connection with sales of the Registrable Securities or resales of Exchange Notes by Participating Broker-Dealers the representations and warranties of
the Company contained in any agreement (including any underwriting agreement) contemplated by Section 5(m) hereof cease to be true and correct, (iv) of the receipt by the Company of any notification with respect to the suspension of the
qualification or exemption from qualification of a Registration Statement or any of the Registrable Securities or the Exchange Notes to be sold by any Participating Broker-Dealer for offer or sale in any jurisdiction, or the initiation or
threatening of any proceeding for such purpose, (v) of the happening of any event, the existence of any condition or any information becoming known that makes any statement made in such Registration Statement or related Prospectus or any
document incorporated therein by reference untrue in any material respect or that requires the making of any changes in or amendments or supplements to such Registration Statement, Prospectus or documents so that, in the case of the Registration
Statement, it will not contain any untrue statement of a material fact or omit to state any material fact required to be stated therein or necessary to make the statements therein not misleading, and that in the case of the Prospectus, it will not
contain any untrue statement of a material fact or omit to state any material fact required to be stated therein or necessary to make the statements therein, in the light of the circumstances under which they were made, not misleading, and
(vi) of the Company’s determination that a post-effective amendment to a Registration Statement would be appropriate. 
 (d)    Use its reasonable best efforts to prevent the issuance of any order suspending the effectiveness of a Registration Statement or of any order preventing or suspending the use of
a Prospectus or suspending the qualification (or exemption from qualification) of any of the Registrable Securities or the Exchange Notes to be sold by any Participating Broker-Dealer, for sale in any jurisdiction. 

(e)    If a Shelf Registration is filed pursuant to Section 3 and if requested
during the Effectiveness Period by the managing underwriter or underwriters (if any) or the Holders of a majority in aggregate principal amount of the Registrable Securities being sold in connection with an Underwritten Offering to include
information with 

  
 13 









 
respect to such Person, or relating to pricing, a plan of distribution, or aggregate amount of securities to be registered, or other information reasonably requested to be included, (i) as
promptly as practicable incorporate in a prospectus supplement or post-effective amendment such information, (ii) make all required filings of such prospectus supplement or such post-effective amendment as soon as practicable after the Company
has received notification of the matters to be incorporated in such prospectus supplement or post-effective amendment and (iii) supplement or make amendments to such Registration Statement. 

(f)    If (1) a Shelf Registration is filed pursuant to Section 3 hereof,
or (2) a Prospectus contained in the Exchange Offer Registration Statement filed pursuant to Section 2 hereof is required to be delivered under the Securities Act by any Participating Broker-Dealer who seeks to sell Exchange Notes during
the Applicable Period, furnish to each selling Holder of Registrable Securities (with respect to a Registration Statement filed pursuant to Section 3 hereof) and to each such Participating Broker-Dealer who so requests (with respect to any such
Registration Statement) and to their respective counsel and each managing underwriter, if any, at the sole expense of the Company, one conformed copy of the Registration Statement or Registration Statements and each post-effective amendment thereto,
including financial statements and schedules, and, if requested, all documents incorporated or deemed to be incorporated therein by reference and all exhibits. 

(g)    If (1) a Shelf Registration is filed pursuant to Section 3 hereof or
(2) a Prospectus contained in the Exchange Offer Registration Statement filed pursuant to Section 2 hereof is required to be delivered under the Securities Act by any Participating Broker-Dealer who seeks to sell Exchange Notes during the
Applicable Period, deliver to each selling Holder of Registrable Securities (with respect to a Registration Statement filed pursuant to Section 3 hereof), or each such Participating Broker-Dealer (with respect to any such Registration
Statement), as the case may be, their respective counsel, and the underwriters, if any, at the sole expense of the Company, as many copies of the Prospectus or Prospectuses (including each form of preliminary prospectus) and each amendment or
supplement thereto and any documents incorporated by reference therein as such Persons may reasonably request; and, subject to the last paragraph of this Section 5, the Company hereby consents to the use of such Prospectus and each amendment or
supplement thereto by each of the selling Holders of Registrable Securities or each such Participating Broker-Dealer, as the case may be, and the underwriters or agents, if any, and dealers, if any, in connection with the offering and sale of the
Registrable Securities covered by, or the sale by Participating Broker-Dealers of the Exchange Notes pursuant to, such Prospectus and any amendment or supplement thereto. 

(h)    Prior to any public offering of Registrable Securities or any delivery of a
Prospectus contained in the Exchange Offer Registration Statement by any Participating Broker-Dealer who seeks to sell Exchange Notes during the Applicable Period, use its 

  
 14 









 
reasonable best efforts to register or qualify, and to cooperate with the selling Holders of Registrable Securities or each such Participating Broker-Dealer, as the case may be, the managing
underwriter or underwriters, if any, and their respective counsel in connection with the registration or qualification (or exemption from such registration or qualification) of such Registrable Securities for offer and sale under the securities or
Blue Sky laws of such jurisdictions within the United States as any selling Holder, Participating Broker-Dealer, or the managing underwriter or underwriters reasonably request in writing; provided, however, that where Exchange Notes
held by Participating Broker-Dealers or Registrable Securities are offered other than through an Underwritten Offering, the Company agrees to cause its counsel to perform Blue Sky investigations and file registrations and qualifications required to
be filed pursuant to this Section 5(h), keep each such registration or qualification (or exemption therefrom) effective during the period such Registration Statement is required to be kept effective and do any and all other acts or things
necessary or advisable to enable the disposition in such jurisdictions of the Exchange Notes held by Participating Broker-Dealers or the Registrable Securities covered by the applicable Registration Statement; provided, however, that
the Company shall not be required to (A) qualify generally to do business in any jurisdiction where it is not then so qualified, (B) take any action that would subject it to general service of process in any such jurisdiction where it is
not then so subject or (C) subject itself to taxation in excess of a nominal dollar amount in any such jurisdiction where it is not then so subject. 

(i)    If a Shelf Registration is filed pursuant to Section 3 hereof, cooperate
with the selling Holders of Registrable Securities and the managing underwriter or underwriters, if any, to facilitate the timely preparation and delivery of certificates representing Registrable Securities to be sold, which certificates shall not
bear any restrictive legends and shall be in a form eligible for deposit with The Depository Trust Company; and enable such Registrable Securities to be in such denominations (subject to applicable requirements contained in the Indenture) and
registered in such names as the managing underwriter or underwriters, if any, or Holders may request. 
 (j)    Use its reasonable best efforts to cause the Registrable Securities covered by the Registration Statement to be registered with or approved by such other U.S. governmental
agencies or authorities as may be necessary to enable the seller or sellers thereof or the underwriter or underwriters, if any, to consummate the disposition of such Registrable Securities, except as may be required solely as a consequence of the
nature of such selling Holder’s business, in which case the Company will cooperate in all respects with the filing of such Registration Statement and the granting of such approvals. 

(k)    If (1) a Shelf Registration is filed pursuant to Section 3 hereof or
(2) a Prospectus contained in the Exchange Offer Registration Statement filed pursuant to Section 2 hereof is required to be delivered under the Securities Act by any Participating Broker-Dealer who seeks to sell Exchange Notes during the
Applicable Period, upon the occurrence of any event contemplated by Section 5(c)(v) or (vi) hereof, as promptly as 

  
 15 









 
practicable prepare and (subject to Section 5(a) hereof) file with the SEC, at the sole expense of the Company, a supplement or post-effective amendment to the Registration Statement or a
supplement to the related Prospectus or any document incorporated therein by reference, or file any other required document so that, as thereafter delivered to the purchasers of the Registrable Securities being sold thereunder (with respect to a
Registration Statement filed pursuant to Section 3 hereof) or to the purchasers of the Exchange Notes to whom such Prospectus will be delivered by a Participating Broker-Dealer (with respect to any such Registration Statement), any such
Prospectus will not contain an untrue statement of a material fact or omit to state a material fact required to be stated therein or necessary to make the statements therein, in the light of the circumstances under which they were made, not
misleading. 
 (l)    Prior to the effective date of the first Registration
Statement relating to the Registrable Securities, (i) provide the Trustee with certificates for the Registrable Securities in a form eligible for deposit with The Depository Trust Company and (ii) provide a CUSIP number for the Registrable
Securities. 
 (m)    In connection with any Underwritten Offering of
Registrable Securities pursuant to a Shelf Registration, enter into an underwriting agreement as is customary in Underwritten Offerings of debt securities similar to the Notes (including, without limitation, a customary condition to the obligations
of the underwriters that the underwriters shall have received “cold comfort” letters and updates thereof in form, scope and substance reasonably satisfactory to the managing underwriter or underwriters from the independent certified public
accountants of the Company (and, if necessary, any other independent certified public accountants of the Company, or of any business acquired by the Company, for which financial statements and financial data are, or are required to be, included or
incorporated by reference in the Registration Statement), addressed to each of the underwriters, such letters to be in customary form and covering matters of the type customarily covered in “cold comfort” letters in connection with
Underwritten Offerings of debt securities similar to the Notes), and take all such other actions as are reasonably requested by the managing underwriter or underwriters in order to expedite or facilitate the registration or the disposition of such
Registrable Securities and, in such connection, (i) make such representations and warranties to, and covenants with, the underwriters with respect to the business of the Company (including any acquired business, properties or entity, if
applicable), and the Registration Statement, Prospectus and documents, if any, incorporated or deemed to be incorporated by reference therein, in each case, as are customarily made by the issuers to underwriters in Underwritten Offerings of debt
securities similar to the Notes, and confirm the same in writing if and when requested, (ii) obtain the written opinions of counsel to the Company, and written updates thereof in form, scope and substance reasonably satisfactory to the managing
underwriter or underwriters, addressed to the underwriters covering the matters customarily covered in opinions reasonably requested in Underwritten Offerings and (iii) if an underwriting agreement is entered into, the same


  
 16 









 
shall contain indemnification provisions and procedures no less favorable to the sellers and underwriters, if any, than those set forth in Section 7 hereof (or such other provisions and
procedures reasonably acceptable to Holders of a majority in aggregate principal amount of Registrable Securities covered by such Registration Statement and the managing underwriter or underwriters or agents, if any). The foregoing shall be done at
each closing under such underwriting agreement, or as and to the extent required thereunder. 

(n)    If (1) a Shelf Registration is filed pursuant to Section 3 hereof,
or (2) a Prospectus contained in the Exchange Offer Registration Statement filed pursuant to Section 2 hereof is required to be delivered under the Securities Act by any Participating Broker-Dealer who seeks to sell Exchange Notes during
the Applicable Period, make available for inspection by any Initial Purchaser, any selling Holder of such Registrable Securities being sold (with respect to a Registration Statement filed pursuant to Section 3 hereof), or each such
Participating Broker-Dealer, as the case may be, any underwriter participating in any such disposition of Registrable Securities, if any, and any attorney, accountant or other agent retained by any such selling Holder or each such Participating
Broker-Dealer (with respect to any such Registration Statement), as the case may be, or underwriter (any such Initial Purchasers, Holders, Participating Broker-Dealers, underwriters, attorneys, accountants or agents, collectively, the
“Inspectors”), upon written request, at the offices where normally kept, during reasonable business hours, all pertinent financial and other records, pertinent corporate documents and instruments of the Company and subsidiaries of
the Company (collectively, the “Records”), as shall be reasonably necessary to enable them to exercise any applicable due diligence responsibilities, and cause the officers, directors and employees of the Company and any of its
subsidiaries to supply all information (“Information”) reasonably requested by any such Inspector in connection with such due diligence responsibilities. Each Inspector shall agree in writing that it will keep the Records and
Information confidential, to use the Information only for due diligence purposes, to abstain from using the Information as the basis for any market transactions in securities of the Company and that they will not disclose any of the Records or
Information that the Company determine, in good faith, to be confidential and notifies the Inspectors in writing are confidential unless (i) the disclosure of such Records or Information is necessary to avoid or correct a misstatement or
omission in such Registration Statement or Prospectus, (ii) the release of such Records or Information is ordered pursuant to a subpoena or other order from a court of competent jurisdiction, (iii) disclosure of such Records or Information
is necessary or advisable, in the opinion of counsel for any Inspector, in connection with any action, claim, suit or proceeding, directly or indirectly, involving or potentially involving such Inspector and arising out of, based upon, relating to,
or involving this Agreement or the Purchase Agreement, or any transactions contemplated hereby or thereby or arising hereunder or thereunder, or (iv) the information in such Records or Information has been made generally available to the public
other than by an Inspector or an “affiliate” (as defined in Rule 405) thereof; provided, however, that prior notice shall be provided as 

  
 17 









 
soon as practicable to the Company of the potential disclosure of any information by such Inspector pursuant to clauses (i) or (ii) of this Section 5(n) to permit the Company to
obtain a protective order (or to waive the provisions of this Section 5(n)) and that such Inspector shall take such actions as are reasonably necessary to protect the confidentiality of such information (if practicable) to the extent such
action is otherwise not inconsistent with, an impairment of or in derogation of the rights and interests of the Holder or any Inspector. 
 (o)    Provide a Trustee for the Registrable Securities or the Exchange Notes, as the case may be, and cause the Indenture or the trust indenture provided for in Section 2(a)
hereof, as the case may be, to be qualified under the TIA not later than the effective date of the first Registration Statement relating to the Registrable Securities; and in connection therewith, cooperate with the Trustee under any such indenture
and the Holders of the Registrable Securities, to effect such changes (if any) to such indenture as may be required for such indenture to be so qualified in accordance with the terms of the TIA; and execute, and use its reasonable best efforts to
cause such Trustee to execute, all documents as may be required to effect such changes, and all other forms and documents required to be filed with the SEC to enable such indenture to be so qualified in a timely manner. 

(p)    Comply in all material respects with all applicable rules and regulations of
the SEC and make generally available to its security holders with regard to any applicable Registration Statement, a consolidated earnings statement satisfying the provisions of Section 11(a) of the Securities Act and Rule 158 thereunder
(or any similar rule promulgated under the Securities Act) no later than 45 days after the end of any fiscal quarter (or 90 days after the end of any 12-month period if such period is a fiscal year) (i) commencing at the end of any
fiscal quarter in which Registrable Securities are sold to underwriters in a firm commitment or best efforts Underwritten Offering and (ii) if not sold to underwriters in such an offering, commencing on the first day of the first fiscal quarter
of the Company, after the effective date of a Registration Statement, which statements shall cover said 12-month periods. 
 (q)    Upon consummation of the Exchange Offer or a Private Exchange, obtain an opinion of counsel to the Company, in a form customary for underwritten transactions, addressed to the
Trustee for the benefit of all Holders of Registrable Securities participating in the Exchange Offer or the Private Exchange, as the case may be, that the Exchange Notes or Private Exchange Notes, as the case may be, the related Guarantees and the
related indenture constitute legal, valid and binding obligations of the Company, enforceable against the Company in accordance with their respective terms, subject to customary exceptions and qualifications. If the Exchange Offer or a Private
Exchange is to be consummated, upon delivery of the Registrable Securities by Holders to the Company (or to such other Person as directed by the Company), in exchange for the Exchange Notes or the Private Exchange Notes, as the case may be, the
Company shall mark, or cause to be marked, on such Registrable Securities that such Registrable 

  
 18 









 
Securities are being cancelled in exchange for the Exchange Notes or the Private Exchange Notes, as the case may be; in no event shall such Registrable Securities be marked as paid or otherwise
satisfied. 
 (r)     Use reasonable efforts to cooperate with each seller
of Registrable Securities covered by any Registration Statement and each underwriter, if any, participating in the disposition of such Registrable Securities and their respective counsel in connection with any filings required to be made with FINRA.

 (s)     Use its reasonable best efforts to take all other steps
reasonably necessary to effect the registration of the Exchange Notes and/or Registrable Securities covered by a Registration Statement contemplated hereby. 
 The Company may require each seller of Registrable Securities as to which any registration is being effected to furnish to the Company such information regarding such seller and the distribution of such
Registrable Securities as the Company may, from time to time, reasonably request. The Company may exclude from such registration the Registrable Securities of any seller so long as such seller fails to furnish such information within a reasonable
time after receiving such request. Each seller as to which any Shelf Registration is being effected agrees to furnish promptly to the Company all information required to be disclosed in order to make the information previously furnished to the
Company by such seller not materially misleading and the Company shall have no responsibility hereunder for the accuracy or completeness of any information so furnished. 

If any such Registration Statement refers to any Holder by name or otherwise as the holder of any securities of the
Company, then such Holder shall have the right to require (i) the insertion therein of language, in form and substance reasonably satisfactory to such Holder, to the effect that the holding by such Holder of such securities is not to be
construed as a recommendation by such Holder of the investment quality of the securities covered thereby and that such holding does not imply that such Holder will assist in meeting any future financial requirements of the Company, or (ii) in
the event that such reference to such Holder by name or otherwise is not required by the Securities Act or any similar federal statute then in force, the deletion of the reference to such Holder in any amendment or supplement to the Registration
Statement filed or prepared subsequent to the time that such reference ceases to be required. 
 Each Holder of
Registrable Securities and each Participating Broker-Dealer agrees by its acquisition of such Registrable Securities or Exchange Notes to be sold by such Participating Broker-Dealer, as the case may be, that, upon actual receipt of any notice from
the Company of the happening of any event of the kind described in Section 5(c)(ii), (iv), (v) or (vi) hereof, such Holder will forthwith discontinue disposition of such Registrable Securities covered by such Registration Statement or
Prospectus or Exchange Notes to be sold by such Holder or Participating Broker-Dealer, as the case may be, until such Holder’s or Participating Broker-Dealer’s receipt of the copies of the supplemented or amended Prospectus contemplated by
Section 5(k) hereof, or until the Company advises it (such written advice from the Company, the 

  
 19 









 
“Advice”) that the use of the applicable Prospectus may be resumed, and has received copies of any amendments or supplements thereto. In the event that the Company shall give any
such notice, each of the Applicable Period and the Effectiveness Period shall be extended by the number of days during such periods from and including the date of the giving of such notice to and including the date when each seller of Registrable
Securities covered by such Registration Statement or Exchange Notes to be sold by such Participating Broker-Dealer, as the case may be, shall have received (x) the copies of the supplemented or amended Prospectus contemplated by
Section 5(k) hereof or (y) the Advice. 
  

	 	6.	 Registration Expenses 


 All of the Company’s and the Guarantors’ fees and expenses incident to the performance of or compliance with this Agreement by the Company of its obligations under Sections 2, 3, 4, 5 and 8
hereof shall be borne by the Company and the Guarantors, whether or not the Exchange Offer Registration Statement or any Shelf Registration Statement is filed or becomes effective or the Exchange Offer is consummated, including, without limitation,
(i) all registration and filing fees (including, without limitation, (A) fees with respect to filings required to be made with FINRA in connection with an Underwritten Offering and (B) fees and expenses of compliance with state
securities or Blue Sky laws (including, without limitation, reasonable fees and disbursements of counsel in connection with Blue Sky qualifications of the Registrable Securities or Exchange Notes and determination of the eligibility of the
Registrable Securities or Exchange Notes for investment under the laws of such jurisdictions in the United States (x) where the Holders of Registrable Securities are located, in the case of the Exchange Notes, or (y) as provided in
Section 5(h) hereof, in the case of Registrable Securities or Exchange Notes to be sold by a Participating Broker-Dealer during the Applicable Period)), (ii) printing expenses, including, without limitation, printing of prospectuses if
requested by the managing underwriter or underwriters, if any, by the Holders of a majority in aggregate principal amount of the Registrable Securities included in any Registration Statement or in respect of Registrable Securities or Exchange Notes
to be sold by any Participating Broker-Dealer during the Applicable Period, as the case may be, (iii) fees and expenses of the Trustee, any exchange agent and their respective counsel, (iv) fees and disbursements of counsel for the Company
and, in the case of a Shelf Registration, reasonable fees and disbursements of one special counsel for all of the sellers of Registrable Securities selected by the Holders of a majority in aggregate principal amount of Registrable Securities covered
by such Shelf Registration (which counsel shall be reasonably satisfactory to the Company) exclusive of any counsel retained pursuant to Section 7 hereof), (v) fees and disbursements of all independent certified public accountants referred
to in Section 5(m) hereof (including, without limitation, the expenses of any “cold comfort” letters required by or incident to such performance), (vi) rating agency fees, if any, and any fees associated with making the
Registrable Securities or Exchange Notes eligible for trading through The Depository Trust Company, (vii) Securities Act liability insurance, if the Company desires such insurance, (viii) fees and expenses of all other Persons retained by
the Company (provided, that any obligation to pay the fees and expenses of any underwriter engaged by the Company will be set forth in a separate underwriting agreement), (ix) internal expenses of the Company


  
 20 









 
(including, without limitation, all salaries and expenses of officers and employees of the Company performing legal or accounting duties), (x) the expense of any annual audit, (xi) any
fees and expenses incurred in connection with the listing of the securities to be registered on any securities exchange, and the obtaining of a rating of the securities, in each case, if applicable, (xii) the expenses relating to printing, word
processing and distributing all Registration Statements, underwriting agreements, indentures and any other documents necessary in order to comply with this Agreement and (xiii) messenger, telephone and delivery expenses relating to the offering
in incurred in connection with the performance of the Company’s obligations hereunder (collectively, the “Registration Expenses”). The Company shall, promptly after receipt of a request therefor, reimburse the Holders in full
for the full amount of the reasonably incurred and documented Registration Expenses paid by the Holders (to the extent any Holders pay any Registration Expenses). 
  

	 	7.	 Indemnification and Contribution. 



(a)    The Company and the Guarantors, jointly and severally, agree to indemnify and hold harmless
each Holder of Registrable Securities, each Participating Broker-Dealer selling Exchange Notes during the Applicable Period, the directors, officers, employees, Affiliates and agents of each such Holder or Participating Broker-Dealer and each
Person, if any, who controls any such Holder or Participating Broker-Dealer or its affiliates within the meaning of Section 15 of the Act or Section 20 of the Exchange Act (each, a “Participant”) against any losses,
claims, damages or liabilities, joint or several, to which any Participant may become subject under the Securities Act, the Exchange Act or otherwise, insofar as any such losses, claims, damages or liabilities (or actions in respect thereof) arise
out of or are based upon: 
 (i)    any untrue statement or alleged untrue
statement of any material fact contained in any Registration Statement (or any amendment thereto), or Prospectus (as amended or supplemented if the Company shall have furnished any amendments or supplements thereto); or 

(ii)    the omission or alleged omission to state, in any Registration Statement (or
any amendment thereto), or Prospectus (as amended or supplemented if the Company shall have furnished any amendments or supplements thereto) or any amendment or supplement thereto, a material fact required to be stated therein or necessary to make
the statements therein not misleading; 
 and agree (subject to the limitations set forth in the proviso to this sentence) to
reimburse, as incurred, the Participant for any reasonable legal or other expenses incurred by the Participant in connection with investigating, defending against or appearing as a third-party witness in connection with any such loss, claim, damage,
liability or action; provided, however, neither the Company nor any Guarantor will be liable in any such case to the extent that any such loss, claim, damage, or liability arises out of or is based upon any untrue statement or alleged
untrue statement or omission or alleged omission made in any Registration Statement (or any amendment thereto), or Prospectus (as amended or supplemented if the Company shall have 

  
 21 









 
furnished any amendments or supplements thereto) or any preliminary prospectus or any amendment or supplement thereto in reliance upon and in conformity with written information relating to any
Participant furnished to the Company by or on behalf of the party claiming indemnification specifically for inclusion therein. The indemnity provided for in this Section 7 shall be in addition to any liability that the Company may otherwise
have to the indemnified parties. 
 (b)     Each Holder of Registrable Securities,
severally and not jointly, agrees to indemnify and hold harmless the Company, the Guarantors, their respective directors (or equivalent), their respective officers who sign any Registration Statement and each person, if any, who controls the Company
within the meaning of Section 15 of the Act or Section 20 of the Exchange Act against any losses, claims, damages or liabilities to which the Company, the Guarantors or any such director, officer or controlling person may become subject
under the Act, the Exchange Act or otherwise, insofar as such losses, claims, damages or liabilities (or actions in respect thereof) arise out of or are based upon (i) any untrue statement or alleged untrue statement of any material fact
contained in any Registration Statement, Prospectus or any amendment or supplement thereto, or (ii) the omission or the alleged omission to state therein a material fact necessary to make the statements therein not misleading, in each case to
the extent, but only to the extent, that such untrue statement or alleged untrue statement or omission or alleged omission was made in reliance upon and in conformity with written information concerning such Holder, furnished to the Company by or on
behalf of such Holder specifically for use therein; and subject to the limitation set forth immediately preceding this clause, will reimburse, as incurred, any reasonable legal or other expenses incurred by the Company, the Guarantors or any such
director, officer or controlling person in connection with investigating or defending against or appearing as a third-party witness in connection with any such loss, claim, damage, liability or action in respect thereof. The indemnity provided for
in this Section 7 will be in addition to any liability that the Holders may otherwise have to the indemnified parties. 
 (c)     Promptly after receipt by an indemnified party under this Section 7 of notice of the commencement of any action, such indemnified party will, if a claim in respect thereof
is to be made against the indemnifying party under this Section 7, notify the indemnifying party of the commencement thereof in writing; but the omission to so notify the indemnifying party (i) will not relieve it from any liability under
paragraph (a) or (b) above unless and to the extent it did not otherwise learn of such action and such failure results in the forfeiture by the indemnifying party of substantial rights and defenses and (ii) will not, in any event,
relieve the indemnifying party from any obligations to any indemnified party other than the indemnification obligation provided in paragraphs (a) and (b) above. The indemnifying party shall be entitled to appoint counsel (including local
counsel) of the indemnifying party’s choice at the indemnifying party’s expense to represent the indemnified party in any action for which indemnification is sought (in which case the indemnifying party shall not thereafter be responsible
for the fees and expenses of any separate counsel, other than local counsel if not appointed by the indemnifying party, retained by the indemnified party or parties except as set forth below); provided, however, that such counsel shall
be reasonably satisfactory to the 

  
 22 









 
indemnified party (and which counsel shall not, except with the consent of the indemnified party, be counsel to the indemnifying party). Notwithstanding the indemnifying party’s election to
appoint counsel (including local counsel) to represent the indemnified party in an action, the indemnified party shall have the right to employ separate counsel (including local counsel), and the indemnifying party shall bear the reasonable fees,
costs and expenses of such separate counsel if: (i) the use of counsel chosen by the indemnifying party to represent the indemnified party would present such counsel with a conflict of interest (based on the advice of counsel to the indemnified
party); (ii) the actual or potential defendants in, or targets of, any such action include both the indemnified party and the indemnifying party and the indemnified party shall have reasonably concluded that there may be legal defenses
available to it and/or other indemnified parties that are different from or additional to those available to the indemnifying party; (iii) the indemnifying party shall not have employed counsel reasonably satisfactory to the indemnified party
to represent the indemnified party within a reasonable period of time after notice of the institution of such action; or (iv) the indemnifying party shall authorize the indemnified party to employ separate counsel at the expense of the
indemnifying party. It is understood and agreed that the indemnifying person shall not, in connection with any proceeding or separate but related or substantially similar proceedings in the same jurisdiction arising out of the same general
allegations or circumstances, be liable for the reasonable fees and expenses of more than one separate firm (in addition to one local counsel per relevant jurisdiction) representing the indemnified parties under paragraph (a) or paragraph
(b) of this Section 7, as the case may be, who are parties to such action or actions. Any such separate firm for any Participants shall be designated in writing by Participants who sold a majority in interest of the Registrable Securities
and Exchange Notes sold by all such Participants in the case of paragraph (a) of this Section 7 or the Company in the case of paragraph (b) of this Section 7. In the event that any Participants are indemnified persons
collectively entitled, in connection with a proceeding or separate but related or substantially similar proceedings in a single jurisdiction, to the payment of fees and expenses of a single separate firm under this Section 7(c), and any such
Participants cannot agree to a mutually acceptable separate firm to act as counsel thereto, then such separate firm for all such Indemnified Persons shall be designated in writing by Participants who sold a majority in interest of the Registrable
Securities and Exchange Notes sold by all such Participants. An indemnifying party shall not be liable under this Section 7 to any indemnified party regarding any settlement or compromise or consent to the entry of any judgment with respect to
any pending or threatened claim, action, suit or proceeding in respect of which indemnification or contribution may be sought hereunder (whether or not the indemnified parties are actual or potential parties to such claim or action) unless such
settlement, compromise or consent is consented to by the indemnifying party, which consent shall not be unreasonably withheld, conditioned or delayed. No indemnifying party shall, without the prior written consent of the indemnified party, effect
any settlement or compromise of any pending or threatened proceeding in respect of which any indemnified party is or could have been a party, or indemnity could have been sought hereunder by any indemnified party, unless such settlement
(A) includes an unconditional written release of the indemnified party, in form and substance reasonably satisfactory to the indemnified party, from all liability on claims that are the subject matter of such proceeding and (B) does not
include any statement as to an admission of fault, culpability 

  
 23 









 
or failure to act by or on behalf of any indemnified party. All fees and expenses reimbursed pursuant to this paragraph (c) shall be reimbursed as they are incurred. 

(d)    After notice from the indemnifying party to such indemnified party of its election so to
assume the defense thereof and approval by such indemnified party of counsel appointed to defend such action, the indemnifying party will not be liable to such indemnified party under this Section 7 for any legal or other expenses, other than
reasonable costs of investigation, subsequently incurred by such indemnified party in connection with the defense thereof, unless the indemnified party shall have employed separate counsel in accordance with the third sentence of paragraph
(c) of this Section 7. After such notice from the indemnifying party to such indemnified party, the indemnifying party will not be liable for the costs and expenses of any settlement of such action effected by such indemnified party
without the prior written consent of the indemnifying party (which consent shall not be unreasonably withheld), unless such indemnified party waived in writing its rights under this Section 7, in which case the indemnified party may effect such
a settlement without such consent. 
 (e)    In circumstances in which the indemnity
agreement provided for in the preceding paragraphs of this Section 7 is unavailable to, or insufficient to hold harmless, an indemnified party in respect of any losses, claims, damages or liabilities (or actions in respect thereof) (other than
by virtue of the failure of an indemnified party to notify the indemnifying party of its right to indemnification pursuant to paragraph (a) or (b) of this Section 7, where such failure materially prejudices the indemnifying party
(through the forfeiture of substantial rights or defenses)), each indemnifying party, in order to provide for just and equitable contribution, shall contribute to the amount paid or payable by such indemnified party as a result of such losses,
claims, damages or liabilities (or actions in respect thereof) in such proportion as is appropriate to reflect (i) the relative benefits received by the indemnifying party or parties on the one hand and the indemnified party on the other from
the offering of the Notes or (ii) if the allocation provided by the foregoing clause (i) is not permitted by applicable law, not only such relative benefits but also the relative fault of the indemnifying party or parties on the one hand
and the indemnified party on the other in connection with the statements or omissions or alleged statements or omissions that resulted in such losses, claims, damages or liabilities (or actions in respect thereof). The relative benefits received by
the Company and the Guarantors on the one hand and such Holder on the other shall be deemed to be in the same proportion that the total net proceeds from the offering (before deducting expenses) of the Notes received by the Company bears to the
total discounts, commissions and other compensation or net proceeds on the sale of Notes received by such Holder in connection with the sale of the Notes (or if such Holder did not receive discounts or commissions, the value of receiving the
“freely tradable” Notes). The relative fault of the parties shall be determined by reference to, among other things, whether the untrue or alleged untrue statement of a material fact or the omission or alleged omission to state a material
fact relates to information supplied by the Company on the one hand, or the Holders on the other, the parties’ relative intent, knowledge, access to information and opportunity to correct or prevent such statement or omission or alleged
statement or omission, and any other equitable considerations appropriate in the circumstances. The parties agree that it would not be 

  
 24 









 
equitable if the amount of such contribution were determined by pro rata or per capita allocation or by any other method of allocation that does not take into account the equitable considerations
referred to in the first sentence of this paragraph (e). Notwithstanding any other provision of this paragraph (e), no Holder shall be obligated to make contributions hereunder that in the aggregate exceed the total discounts, commissions and
other compensation or net proceeds on the sale of Notes received by such Holder in connection with the sale of the Notes, less the aggregate amount of any damages that such Holder has otherwise been required to pay by reason of the untrue or alleged
untrue statements or the omissions or alleged omissions to state a material fact, and no person guilty of fraudulent misrepresentation (within the meaning of Section 11(f) of the Act) shall be entitled to contribution from any person who was
not guilty of such fraudulent misrepresentation. For purposes of this paragraph (e), each person, if any, who controls a Holder within the meaning of Section 15 of the Act or Section 20 of the Exchange Act shall have the same rights to
contribution as such Holder, and each director of the Company and the Guarantors, each officer of the Company and the Guarantors and each person, if any, who controls the Company and the Guarantors within the meaning of Section 15 of the Act or
Section 20 of the Exchange Act, shall have the same rights to contribution as the Company. The Holders’ obligations to contribute pursuant to this paragraph (e) are several in proportion to the respective principal amount of the
Registrable Securities held by each Holder hereunder and not joint. 
  

	 	8.	 Rule 144A 


 (a)     Facilitation of Sales Pursuant to Rule 144A.    The Company covenants and agrees that it will use reasonable best efforts to file the reports
required to be filed by it under the Securities Act and the Exchange Act and the rules and regulations adopted by the SEC thereunder in a timely manner in accordance with the requirements of the Securities Act and the Exchange Act and, if at any
time the Company is not required to file such reports, the Company will, upon the request of any Holder or beneficial owner of Registrable Securities, make available such information necessary to permit sales pursuant to Rule 144A. The Company
further covenants and agrees, for so long as any Registrable Securities remain outstanding, that it will take such further action as any Holder of Registrable Securities may reasonably request, all to the extent required from time to time to enable
such Holder to sell Registrable Securities without registration under the Securities Act within the limitation of the exemptions provided by Rule 144A unless the Company is then subject to Section 13 or 15(d) of the Exchange Act and
reports filed thereunder satisfy the information requirements of Rule 144A then in effect. Upon the request of any Holder, the Company shall deliver to such Holder a written statement as to whether it has complied with such information and
requirements. 
 (b)     Availability of Rule 144A Not Excuse of Obligations under
Section 2 of this Agreement.    The fact that Holders of Registrable Securities may become eligible to sell such Registrable Securities pursuant to Rule 144 shall not (1) cause such Notes to cease to be Registrable
Securities or (2) excuse the Company’s and the Guarantor’s obligations set forth in Section 2 of this Agreement, including without limitation the obligations in respect of an Exchange Offer, Shelf Registration and Additional
Interest. 

  
 25 










	 	9.	 Underwritten Registrations 


 The Company shall not be required to assist in an Underwritten Offering unless requested by the Holders of a majority in aggregate principal amount of the Registrable Securities. If any of the Registrable
Securities covered by any Shelf Registration are to be sold in an Underwritten Offering, the investment banker or investment bankers and manager or managers that will manage the offering will be selected by the Holders of a majority in aggregate
principal amount of such Registrable Securities included in such offering and shall be reasonably acceptable to the Company. 
 No Holder of Registrable Securities may participate in any Underwritten Registration hereunder unless such Holder (a) agrees to sell such Holder’s Registrable Securities on the basis provided in
any underwriting arrangements approved by the Persons entitled hereunder to approve such arrangements and (b) completes and executes all questionnaires, powers of attorney, indemnities, underwriting agreements and other documents required under
the terms of such underwriting arrangements. 
  

	 	10.	 Miscellaneous 


 (a)    Remedies.    Each of the Company and the Guarantors hereby agrees that monetary damages would not be adequate compensation for any loss incurred by
reason of a breach by it of the provisions of this Agreement and hereby agrees to waive the defense in any action for specific performance that a remedy at law would be adequate. 

(b)    No Inconsistent Agreements.    The Company has not as of the date
hereof, and the Company shall not, after the date of this Agreement, enter into any agreement with respect to any of its securities that is inconsistent with the rights granted to the Holders of Registrable Securities in this Agreement or otherwise
conflicts with the provisions hereof. The rights granted to the Holders hereunder do not in any way conflict with and are not inconsistent with the rights granted to the holders of the Company’s other issued and outstanding securities under any
such agreements. The Company will not enter into any agreement (other than this Agreement in respect of the Notes) with respect to any of its securities which will grant to any Person piggy-back registration rights with respect to any Registration
Statement. 
 (c)    Adjustments Affecting Registrable
Securities.    The Company shall not, directly or indirectly, take any action with respect to the Registrable Securities as a class that would adversely affect the ability of the Holders of Registrable Securities to include
such Registrable Securities in a registration undertaken pursuant to this Agreement. 

(d)    Amendments and Waivers.    The provisions of this Agreement may
not be amended, modified or supplemented, and waivers or consents to departures from the provisions hereof may not be given, otherwise than with the prior written consent of (I) the Company, and (II) (A) the Holders of not less than a
majority in aggregate principal amount of the then outstanding Registrable Securities and (B) in circumstances that would adversely affect the 

  
 26 









 
Participating Broker-Dealers, the Participating Broker-Dealers holding not less than a majority in aggregate principal amount of the Exchange Notes held by all Participating Broker-Dealers;
provided, however, that Section 7 hereof and this Section 10(d) may not be amended, modified or supplemented without the prior written consent of each Holder and each Participating Broker-Dealer (including any person who was
a Holder or Participating Broker-Dealer of Registrable Securities or Exchange Notes, as the case may be, disposed of pursuant to any Registration Statement) affected by any such amendment, modification or supplement. Notwithstanding the foregoing, a
waiver or consent to depart from the provisions hereof with respect to a matter that relates exclusively to the rights of Holders of Registrable Securities whose securities are being sold pursuant to a Registration Statement and that does not
directly or indirectly affect, impair, limit or compromise the rights of other Holders of Registrable Securities may be given by Holders of at least a majority in aggregate principal amount of the Registrable Securities being sold pursuant to such
Registration Statement. 
 (e)    Notices.    All notices and
other communications (including, without limitation, any notices or other communications to the Trustee) provided for or permitted hereunder shall be made in writing by hand-delivery, registered first-class mail, next-day air courier or facsimile,
if applicable: 
 (i)    if to a Holder of the Registrable Securities, or
any Participating Broker-Dealer, at the most current address of such Holder, or Participating Broker-Dealer, as the case may be, set forth on the records of the registrar under the Indenture, with a copy in like manner to the Initial Purchasers as
follows: 
 Deutsche Bank Securities Inc. 

60 Wall Street, Second Floor 
 New York, NY 10005 
 Facsimile No.: (212) 797-4877

 Attention: Leveraged Debt Capital Markets 

with a copy to: 
 Deutsche Bank Securities Inc. 
 60 Wall Street, 36th Floor

 New York, NY 10005 
 Facsimile No.: (212) 797-4561 
 Attention: General Counsel

 and 
 Wells Fargo Securities, LLC 
 301 South College Street, 6th Floor

 Charlotte, NC 28202 
 Facsimile No.: (704) 383-0661 

  
 27 









 Attention: High Yield Syndicate 

(ii)     if to the Initial Purchasers, at the address specified in
Section 10(e)(i) hereof; 
 (iii)   if to the Company, at the address as follows:

 Health Management Associates, Inc. 

5811 Pelican Bay Boulevard, Suite 500 

Naples, FL 34108-2710 
 with a copy to: 
 Health Management Associates, Inc. 

5811 Pelican Bay Boulevard, Suite 500 

Naples, FL 34108-2710 
 All such notices and communications shall be deemed to have been duly given: when delivered by hand, if personally delivered; five Business Days after being deposited in the mail, postage prepaid, if
mailed; one Business Day after being timely delivered to a next-day air courier; and upon written confirmation, if sent by facsimile. 
 Copies of all such notices, demands or other communications shall be concurrently delivered by the Person giving the same to the Trustee at the address and in the manner specified in such Indenture.

 (f)    Successors and Assigns.    This Agreement shall inure
to the benefit of and be binding upon the successors and assigns of each of the parties hereto, the Holders and the Participating Broker-Dealers; provided, however, that nothing herein shall be deemed to permit any assignment, transfer
or other disposition of Registrable Securities in violation of the terms of the Purchase Agreement or the Indenture. 
 (g)    Counterparts.    This Agreement may be executed in any number of counterparts and by the parties hereto in separate counterparts, each of which when
so executed shall be deemed to be an original and all of which taken together shall constitute one and the same agreement. 
 (h)    Headings.    The headings in this Agreement are for convenience of reference only and shall not limit or otherwise affect the meaning hereof.

 (i)    Governing Law; Waiver of Jury Trial.    THIS AGREEMENT
SHALL BE GOVERNED BY, AND CONSTRUED IN ACCORDANCE WITH, THE LAW OF THE STATE OF NEW YORK, INCLUDING, WITHOUT LIMITATION, SECTION 5-1401 OF THE NEW YORK GENERAL OBLIGATIONS LAW. EACH OF THE PARTIES HEREBY


  
 28 









 
WAIVES ANY RIGHT TO TRIAL BY JURY IN ANY ACTION, PROCEEDING OR COUNTERCLAIM ARISING OUT OF OR RELATING TO THIS AGREEMENT. 

(j)    Severability.    If any term, provision, covenant or restriction
of this Agreement is held by a court of competent jurisdiction to be invalid, illegal, void or unenforceable, the remainder of the terms, provisions, covenants and restrictions set forth herein shall remain in full force and effect and shall in no
way be affected, impaired or invalidated, and the parties hereto shall use their best efforts to find and employ an alternative means to achieve the same or substantially the same result as that contemplated by such term, provision, covenant or
restriction. It is hereby stipulated and declared to be the intention of the parties that they would have executed the remaining terms, provisions, covenants and restrictions without including any of such that may be hereafter declared invalid,
illegal, void or unenforceable. 
 (k)    Notes Held by the Company or its
Affiliates.    Whenever the consent or approval of Holders of a specified percentage of Registrable Securities is required hereunder, Registrable Securities held by the Company or its affiliates (as such term is defined in
Rule 405 under the Securities Act) shall not be counted in determining whether such consent or approval was given by the Holders of such required percentage. 

(l)    Third-Party Beneficiaries.    Holders of Registrable Securities
and Participating Broker-Dealers are intended third-party beneficiaries of this Agreement, and this Agreement may be enforced by such Persons. 
 (m)    Entire Agreement.    This Agreement, together with the Purchase Agreement and the Indenture, is intended by the parties as a final and exclusive
statement of the agreement and understanding of the parties hereto in respect of the subject matter contained herein and therein and any and all prior oral or written agreements, representations, or warranties, contracts, understandings,
correspondence, conversations and memoranda between the Holders on the one hand and the Company on the other, or between or among any agents, representatives, parents, subsidiaries, affiliates, predecessors in interest or successors in interest with
respect to the subject matter hereof and thereof are merged herein and replaced hereby. 
 [Remainder of page intentionally left
blank.] 

  
 29 









 IN WITNESS WHEREOF, the parties have executed this Agreement as of the date
first written above. 
  

					
	 The Company:
  

HEALTH MANAGEMENT ASSOCIATES, INC.

		
	 By:
	 	 \s\ Timothy R. Parry

		 	 Name: 
	 	 Timothy R. Parry

		 	   Title:
	 	 Senior Vice President, General Counsel and Secretary



 Signature Page to Registration Rights Agreement 







 The
Guarantors:             

			
		  	AMORY HMA, LLC
		  	BARTOW HMA, LLC
		  	BILOXI H.M.A., LLC
		  	BRANDON HMA, LLC
		  	BREVARD HMA HOLDINGS, LLC
		  	BREVARD HMA HOSPITALS, LLC
		  	CAMPBELL COUNTY HMA, LLC
		  	CAROLINAS JV HOLDINGS GENERAL
		  	CAROLINAS JV HOLDINGS, L.P.
		  	CENTRAL FLORIDA HMA HOLDINGS, LLC
		  	CENTRAL STATES HMA HOLDINGS, LLC
		  	CHESTER HMA, LLC
		  	CITRUS HMA, LLC
		  	CLARKSDALE HMA, LLC
		  	COCKE COUNTY HMA, LLC
		  	FLORIDA HMA HOLDINGS, LLC
		  	FORT SMITH HMA, LLC
		  	HAMLET H.M.A., LLC
		  	HEALTH MANAGEMENT ASSOCIATES, LLC
		  	HMA FENTRESS COUNTY GENERAL HOSPITAL, LLC
		  	HMA HOSPITALS HOLDINGS, LLC
		  	HMA SANTA ROSA MEDICAL CENTER, LLC
		  	HOSPITAL MANAGEMENT ASSOCIATES, INC.
		  	JACKSON HMA, LLC
		  	JEFFERSON COUNTY HMA, LLC
		  	KENNETT HMA, LLC
		  	KEY WEST HMA, LLC
		  	KNOXVILLE HMA HOLDINGS, LLC
		  	LEHIGH HMA, LLC
		  	LONE STAR HMA, L.P.
		  	MADISON HMA, LLC
		  	MELBOURNE HMA, LLC
		  	MESQUITE HMA GENERAL, LLC
		  	METRO KNOXVILLE HMA, LLC
		  	MISSISSIPPI HMA HOLDINGS I, LLC
		  	MISSISSIPPI HMA HOLDINGS II, LLC
		  	MONROE HMA, LLC
		  	NAPLES HMA, LLC
		  	PORT CHARLOTTE HMA, LLC
		  	PUNTA GORDA HMA, LLC
		  	RIVER OAKS HOSPITAL, LLC
		  	ROCKLEDGE HMA, LLC
		  	ROH, LLC
		  	SEBASTIAN HOSPITAL, LLC
		  	SEBRING HOSPITAL MANAGEMENT ASSOCIATES, LLC
		  	SOUTHEAST HMA HOLDINGS, LLC
		  	SOUTHWEST FLORIDA HMA HOLDINGS, LLC
		  	STATESVILLE HMA, LLC
		  	VENICE HMA, LLC
		  	WINDER HMA, LLC
		
		  	 By: \s\ Timothy R. Parry

		  	Name:  Timothy R. Parry
		  	Title:    Senior Vice President, General Counsel and Secretary

 Signature Page to Registration Rights Agreement 








			
	 The foregoing Agreement is hereby confirmed and accepted as of the date first above written.

 
 DEUTSCHE BANK SECURITIES INC.

 
 for itself and as a Representative

    of the other Initial Purchasers

		
	 By:  
	 	 \s\ William Frauen

		 	 Name:  William Frauen

		 	 Title:    Managing Director

		
	 By:
	 	 \s\ Alexandra Barth

		 	 Name:  Alexandra Barth

		 	 Title:    Managing Director


 Signature Page to Registration Rights Agreement 








			
	 WELLS FARGO SECURITIES, LLC

 
 for itself and as a Representative

    of the other Initial Purchasers

		
	 By:  
	 	 \s\ Chris McCoy

		 	 Name:  Chris McCoy

		 	 Title:    Director


 Signature Page to Registration Rights Agreement