Document:

EX-10.1

 Exhibit 10.1 

TENET HEALTHCARE CORPORATION 

Floating Rate Senior Secured Notes due 2020 

unconditionally guaranteed as to the 

payment of principal, premium. 

if any, and interest by the 

Guarantors named on Schedule I hereto 
  

 

Exchange and Registration Rights Agreement 

June 16, 2015 
 Barclays Capital Inc. 

745 Seventh Avenue 
 New York, NY 10019 

As Representative of the Initial Purchasers 
 Ladies and
Gentlemen: 
 Tenet Healthcare Corporation, a Nevada corporation (the “Company”), issued on the Closing Date (as defined herein), $900.0
million in aggregate principal amount of its Floating Rate Senior Secured Notes due 2020 (the “Notes”). The Notes are unconditionally guaranteed by the Guarantors (as defined herein), upon the terms and conditions set forth in that
certain Offering Memorandum, dated June 2, 2015, and that certain Purchase Agreement (the “Purchase Agreement”), dated as of June 2, 2015, among the Company, the subsidiaries of the Company set forth on the signature pages
thereto (the “Guarantors”) and Barclays Capital Inc., as representative (the “Representative”) of the several Initial Purchasers (as defined herein). As an inducement to purchase the Notes, and in satisfaction of a
condition to the obligations of the Company under the Purchase Agreement, the Company and the Guarantors agree with the Representative, for the benefit of the holders (as defined herein) from time to time of the Registrable Securities (as defined
herein), as follows: 
 1. Certain Definitions. For purposes of this Exchange and Registration Rights Agreement (this
“Agreement”), the following terms shall have the following respective meanings: 
 “Base Indenture” shall
mean the indenture, dated as of November 6, 2001 between the Company and The Bank of New York Mellon Trust Company N.A., as successor trustee to The Bank of New York, as Trustee. 

“Base Interest” shall mean the interest that would otherwise accrue on the Securities under the terms thereof and the
Indenture, without giving effect to the provisions of this Agreement. 

 The term “broker-dealer” shall mean any broker or dealer registered with the
Commission under the Exchange Act. 
 “Business Day” shall have the meaning set forth in Rule 13e-4(a)(3) promulgated by
the Commission under the Exchange Act, as the same may be amended or succeeded from time to time. 
 “Closing Date” shall
mean June 16, 2015, which is the date of original issuance of the Securities. 
 “Commission” shall mean the United
States Securities and Exchange Commission, or any other federal agency at the time administering the Exchange Act or the Securities Act, whichever is the relevant statute for the particular purpose. 

“Company” shall have the meaning assigned thereto in the preamble. 

“Consummation Date” shall have the meaning assigned thereto in Section 2(a) hereof. 

“Effective Time” shall mean the time and date as of which the Commission declares the Exchange Registration Statement
effective or as of which the Exchange Registration Statement otherwise becomes effective. 
 “Exchange Act” shall mean the
Securities Exchange Act of 1934, as amended, or any successor thereto, as the same may be amended or succeeded from time to time. 

“Exchange Offer” shall have the meaning assigned thereto in Section 2(a) hereof. “Exchange Registration” shall
have the meaning assigned thereto in Section 3(c) hereof. 
 “Exchange Registration Statement” shall have the meaning
assigned thereto in Section 2(a) hereof. 
 “Exchange Securities” shall have the meaning assigned thereto in
Section 2(a) hereof. 
 “FINRA” shall mean the Financial Industry Regulatory Authority, Inc. 

“Free Trade Date” shall mean the 380th day following the Closing Date. 

“Freely Tradable” shall mean, with respect to the Securities at any time of determination. that (a) all outstanding
Securities are eligible to be sold by a person who has not been an “affiliate” (as defined in Rule 405 under the Securities Act) of the Company or any Guarantor during the preceding 90 days without any volume or manner of sale restrictions
under the Securities Act, (b) the Company has provided a certificate to the Trustee instructing the Trustee that the restrictive legend on the Securities no longer applies and (c) the Securities have been assigned an unrestricted CUSIP
number. 
 “Guarantors” shall have the meaning assigned thereto in the preamble. 

  
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 The term “holder” shall mean each of the persons who acquire Registrable
Securities from time to time (including any successors or assigns), in each case for so long as such person owns any Registrable Securities. 

“Indenture” shall mean the Base Indenture, as supplemented by the Supplemental Indenture. 

“Initial Purchasers” shall mean Barclays Capital Inc., Citigroup Global Markets Inc., Deutsche Bank Securities Inc., Goldman,
Sachs & Co., RBC Capital Markets, LLC and SunTrust Robinson Humphrey, Inc. 
 “Notes” shall have the meaning
assigned thereto in the preamble. 
 The term “person” shall mean any individual, corporation, partnership, limited
liability company, joint venture, trust, unincorporated organization or government or any agency or political subdivision thereof. 

“Purchase Agreement” shall have the meaning assigned thereto in the preamble. 

“Registrable Securities” shall mean the Securities; provided, however, that a Security shall cease to be a
Registrable Security upon the earliest to occur of the following: (a) in the circumstances contemplated by Section 2(a) hereof, the Security has been exchanged for an Exchange Security in an Exchange Offer as contemplated in
Section 2(a) hereof (provided that any Exchange Security that, pursuant to the second to last and third to last sentences of Section 2(a), is included in a prospectus for use in connection with resales by broker-dealers shall be
deemed to be a Registrable Security with respect to Sections 5, 6 and 9 until resale of such Registrable Security has been effected within the Resale Period); (b) the Securities become Freely Tradable or (c) such Security shall cease to be
outstanding. 
 “Registration Default” shall have the meaning assigned thereto in Section 2(b) hereof. 

“Registration Default Period” shall have the meaning assigned thereto in Section 2(b) hereof. 

“Registration Expenses” shall have the meaning assigned thereto in Section 4 hereof. 

“Representative” shall have the meaning assigned thereto in the preamble. 

“Resale Period” shall have the meaning assigned thereto in Section 2(a) hereof. 

“Restricted Holder” shall mean (i) a holder that is an affiliate of the Company within the meaning of Rule 405,
(ii) a holder who acquires Exchange Securities outside the ordinary course of such holder’s business, (iii) a holder who has arrangements or understandings with any person to participate in the Exchange Offer for the purpose of
distributing Exchange Securities and (iv) a holder that is a broker-dealer, but only with respect to Exchange Securities received by such broker-dealer pursuant to an Exchange Offer in exchange for Registrable Securities acquired by the
broker-dealer directly from the Company. 

  
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 “Rule 144,” “Rule 405,” “Rule 415” and
“Rule 433” shall mean, in each case, such rule promulgated by the Commission under the Securities Act (or any successor provision), as the same may be amended or succeeded from time to time. 

“Securities” shall mean the Notes, and securities issued in exchange therefor or in lieu thereof pursuant to the Indenture.
Each Security is entitled to the benefit of the guarantees provided for in the Indenture (the “Guarantees”) and, unless the context otherwise requires, any reference herein to a “Security,” an “Exchange Security”
or a “Registrable Security” shall include the related Guarantees. 
 “Securities Act” shall mean the Securities
Act of 1933, as amended, or any successor thereto, as the same may be amended or succeeded from time to time. 
 “Special
Interest” shall have the meaning assigned thereto in Section 2(b) hereof. 
 “Supplemental Indenture” shall
mean the twenty-sixth supplemental indenture, dated as of June 16, 2015, between the Company, the Guarantors and the Trustee, as the same shall be supplemented or amended from time to time. 

“Trust Indenture Act” shall mean the Trust Indenture Act of 1939, as amended, or any successor thereto, and the rules,
regulations and forms promulgated thereunder, all as the same may be amended or succeeded from time to time. 
 “Trustee”
shall mean The Bank of New York Mellon Trust Company, N.A., as trustee under the Indenture, together with any successors in such capacity. 

Unless the context otherwise requires, any reference herein to a “Section” or “clause” refers to a Section or clause, as
the case may be, of this Agreement, and the words “herein,” “hereof” and “hereunder” and other words of similar import refer to this Agreement as a whole and not to any particular Section or other subdivision. 

2. Registration Under the Securities Act. 

(a) Subject to the last sentence of this Section 2(a), if the Securities have not become Freely Tradable on or before the Free Trade
Date, the Company and the Guarantors agree to use all commercially reasonable efforts to (i) file under the Securities Act a registration statement relating to an offer to exchange (such registration statement, the “Exchange
Registration Statement,” and such offer, the “Exchange Offer”) any and all of the Securities for a like aggregate principal amount of debt securities issued by the Company and guaranteed by the Guarantors, which debt
securities and guarantees are substantially identical to the Securities and the related Guarantees, respectively (and are entitled to the benefits of a trust indenture that is substantially identical to the Indenture or is the Indenture and that has
been qualified under the Trust Indenture Act), except that they have been registered pursuant to an effective registration statement under the Securities Act and do not contain provisions for the additional interest contemplated in Section 2(b)
below (such new debt securities are hereinafter called “Exchange Securities”), (ii) cause the Exchange Registration Statement to become effective under the Securities Act, (iii) commence the Exchange Offer promptly after
such Exchange Registration Statement has become effective, (iv) hold the Exchange Offer open for at least 20 Business Days 

  
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(or longer if required by applicable law) after the date that notice of the Exchange Offer is mailed to holders of the Securities, (v) exchange Exchange Securities for all Registrable
Securities that have been properly tendered and not withdrawn on or prior to the expiration of the Exchange Offer and (vi) consummate the Exchange Offer on the earliest practicable date after the Exchange Registration Statement has become
effective, but in no event later than 30 Business Days thereafter (such 30th Business Day being the “Consummation Date”). The Exchange Offer will be registered under the Securities Act on the appropriate form and will comply with
all applicable tender offer rules and regulations under the Exchange Act. The Exchange Offer will be deemed to have been “completed” only (A) if the debt securities and related guarantees received by holders other than Restricted
Holders in the Exchange Offer for Registrable Securities are, upon receipt, transferable by each such holder without restriction under the Securities Act and the Exchange Act and without material restrictions under the blue sky or securities laws of
a substantial majority of the states of the United States of America, and (B) upon the earlier to occur of (1) the Company having exchanged the Exchange Securities for all outstanding Registrable Securities pursuant to the Exchange Offer
and (2) the Company having exchanged, pursuant to the Exchange Offer, Exchange Securities for all Registrable Securities that have been properly tendered and not withdrawn before the expiration of the Exchange Offer, which shall be on a date
that is at least 20 Business Days following the commencement of the Exchange Offer. The Company and the Guarantors agree (I) to include in the Exchange Registration Statement a prospectus for use in any resales by any holder of Exchange
Securities that is a broker-dealer and (II) to keep such Exchange Registration Statement effective for a period (the “Resale Period”) beginning when Exchange Securities are first issued in the Exchange Offer and ending upon the
earlier of the expiration of the 180th day after the Exchange Offer has been completed or such time as such broker-dealers no longer own any Registrable Securities. With respect to such Exchange Registration Statement, such holders shall have the
benefit of the rights of indemnification and contribution set forth in Sections 6(a), (b), (c) and (d) hereof. The obligations of the Company and the Guarantors set forth in this Section 2(a) shall cease on the date on which the
Securities become Freely Tradable. 
 (b) If (i) the Exchange Offer has not been consummated prior to the Consummation Date,
(ii) the Securities have not become Freely Tradable on or before the Free Trade Date, or (iii) any Exchange Registration Statement required by this Agreement is filed and declared effective, but shall thereafter cease to be effective or
fail to be usable for its intended purpose without being succeeded by a post-effective amendment or prospectus supplement to such Exchange Registration Statement that cures such failure and that is itself declared effectively promptly (each such
event referred to in clauses (i) through (iii), a “Registration Default,” and the period during which a Registration Default has occurred and is continuing, the “Registration Default Period”), then, as
liquidated damages for such Registration Default, subject to the provisions of Section 8(b), special interest (“Special Interest”), in addition to the Base Interest, shall accrue at a per annum rate of 0.25% for the first 90
days of the Registration Default Period, at a per annum rate of 0.50% for the second 90 days of the Registration Default Period, at a per annum rate of 0.75% for the third 90 days of the Registration Default Period and at a per annum rate of 1.0%
thereafter for the remaining portion of the Registration Default Period, provided that in no event shall the Company be required to pay Special Interest for more than one Registration Default at any given time. The Registration Default Period
shall terminate on the date on which (i) the Securities become Freely Tradable or (ii) the Exchange Registration Statement has been declared effective and the Exchange Offer has been consummated. Special Interest shall not

  
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accrue as a result of the Company’s failure to provide a certificate to the Trustee instructing the Trustee that the restrictive legend on the Securities no longer applies unless the Company
has received a request to do so by a holder of Securities or the Trustee on or after the 365th day after the Closing Date; provided that if the Company receives such a request on or after the fifth Business Day immediately preceding the Free Trade
Date and the restrictive legend on the Securities has not been removed by the close of business on the fifth Business Day thereafter, Special Interest shall accrue as provided in this Section 2(b) until the date on which (i) the Securities
become Freely Tradable or (ii) the Exchange Registration Statement has been declared effective and the Exchange Offer has been consummated. 

(c) The Company shall take, and shall cause the Guarantors to take, all actions necessary or advisable to be taken to ensure that the
transactions contemplated herein are effected as so contemplated, including all actions necessary or desirable to register the Guarantees under the Exchange Registration Statement contemplated in Section 2(a) hereof. 

(d) Any reference herein to a registration statement or prospectus as of any time shall be deemed to include any document incorporated, or
deemed to be incorporated, therein by reference as of such time and any reference herein to any post-effective amendment to a registration statement or to any prospectus supplement as of any time shall be deemed to include any document incorporated,
or deemed to be incorporated, therein by reference as of such time. 
 3. Registration Procedures. 

If the Company and the Guarantors file a registration statement pursuant to Section 2(a), the following provisions shall apply: 

(a) At or before the Effective Time of the Exchange Registration, the Company and the Guarantors shall qualify the Indenture under the Trust
Indenture Act. 
 (b) In the event that such qualification would require the appointment of a new trustee under the Indenture, the Company
and the Guarantors shall appoint a new trustee thereunder pursuant to the applicable provisions of the Indenture. 
 (c) In connection with
the Company’s and the Guarantors’ obligations with respect to the registration of Exchange Securities as contemplated by Section 2(a) (the “Exchange Registration”), if applicable, the Company and the Guarantors shall,
as soon as practicable (or as otherwise specified): 
 (i) prepare and file with the Commission an Exchange Registration
Statement on any form that may be utilized by the Company and the Guarantors and that shall permit the Exchange Offer and resales of Exchange Securities by broker-dealers during the Resale Period to be effected as contemplated by Section 2(a),
and use all commercially reasonable efforts to cause such Exchange Registration Statement to become effective; 
 (ii)
prepare and file with the Commission such amendments and supplements to such Exchange Registration Statement and the prospectus included therein as may be necessary to effect and maintain the effectiveness of such Exchange Registration

  
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Statement for the periods and purposes contemplated in Section 2(a) hereof and as may be required by the applicable rules and regulations of the Commission and the instructions applicable to
the form of such Exchange Registration Statement, and promptly provide each broker-dealer holding Exchange Securities with such number of copies of the prospectus included therein (as then amended or supplemented), in conformity in all material
respects with the requirements of the Securities Act and the Trust Indenture Act and the rules and regulations of the Commission thereunder, as such broker-dealer reasonably may request prior to the expiration of the Resale Period, for use in
connection with resales of Exchange Securities; 
 (iii) notify each broker-dealer that has requested or received copies of
the prospectus included in such Exchange Registration Statement, and confirm such advice in writing, (A) when such Exchange Registration Statement or the prospectus included therein or any prospectus amendment or supplement or post-effective
amendment has been filed, and, with respect to such Exchange Registration Statement or any post-effective amendment, when the same has become effective, (B) of any comments by the Commission and by the blue sky or securities commissioner or
regulator of any state with respect thereto or any request by the Commission for amendments or supplements to such Exchange Registration Statement or prospectus or for additional information, (C) of the issuance by the Commission of any stop
order suspending the effectiveness of such Exchange Registration Statement or the initiation or threatening of any proceedings for that purpose, (D) if at any time the representations and warranties of the Company and the Guarantors
contemplated by Section 5 cease to be true and correct in all material respects, (E) of the receipt by the Company of any notification with respect to the suspension of the qualification of the Exchange Securities for sale in any
jurisdiction or the initiation or threatening of any proceeding for such purpose, or (F) at any time during the Resale Period when a prospectus is required to be delivered under the Securities Act, that such Exchange Registration Statement,
prospectus, prospectus amendment or supplement or post-effective amendment does not conform in all material respects to the applicable requirements of the Securities Act and the Trust Indenture Act and the rules and regulations of the Commission
thereunder or contains an untrue statement of a material fact or omits to state any material fact required to be stated therein or necessary to make the statements therein not misleading in light of the circumstances then existing; 

(iv) in the event that the Company and the Guarantors would be required, pursuant to Section 3(c)(iii)(F) above, to notify
any broker-dealers holding Exchange Securities, prepare and furnish to each such holder a reasonable number of copies of a prospectus supplemented or amended so that, as thereafter delivered to purchasers of such Exchange Securities during the
Resale Period, such prospectus shall conform in all material respects to the applicable requirements of the Securities Act and the Trust Indenture Act and the rules and regulations of the Commission thereunder and shall 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 not misleading in light of the circumstances then existing; 

  
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 (v) use all commercially reasonable efforts to obtain the withdrawal of any order
suspending the effectiveness of such Exchange Registration Statement or any post-effective amendment thereto at the earliest practicable date; 

(vi) use all commercially reasonable efforts to (A) register or qualify the Exchange Securities under the securities laws
or blue sky laws of such jurisdictions as are contemplated by Section 2(a) no later than the commencement of the Exchange Offer, (B) keep such registrations or qualifications in effect and comply with such laws so as to permit the
continuance of offers, sales and dealings therein in such jurisdictions until the expiration of the Resale Period and (C) take any and all other actions as may be reasonably necessary or advisable to enable each broker-dealer holding Exchange
Securities to consummate the disposition thereof in such jurisdictions; provided, however, that neither the Company nor any of the Guarantors shall be required for any such purpose to (1) qualify as a foreign corporation in any jurisdiction
wherein it would not otherwise be required to qualify but for the requirements of this Section 3(c)(vi), (2) consent to general service of process in any such jurisdiction or (3) in the case of the Company, make any changes to its
certificate of incorporation or bylaws or any agreement between it and its stockholders, and in the case of the Guarantors, make any changes to (x) the certificate (or articles) of incorporation, certificate (or articles) of organization,
certificate (or articles) of formation or certificate of limited partnership, as the case may be, and any amendments thereto, of any Guarantor, (y) the bylaws, limited liability company agreement, operating agreement or partnership agreement,
as the case may be, and any amendments thereto, of any Guarantor or (z) any agreement between any Guarantor and its stockholders, shareholders, members or partners; 

(vii) use all commercially reasonable efforts to obtain the consent or approval of each governmental agency or authority,
whether federal, state or local, that may be required to effect the Exchange Registration, the Exchange Offer and the offering and sale of Exchange Securities by broker-dealers during the Resale Period; 

(viii) provide a CUSIP number for all Exchange Securities, not later than the applicable Effective Time; and 

(ix) comply with all applicable rules and regulations of the Commission, and make generally available to its security holders
as soon as practicable but no later than 18 months after the Effective Time of such Exchange Registration Statement, an earnings statement of the Company and its subsidiaries complying with Section 11(a) of the Securities Act (including, at the
option of the Company, Rule 158 thereunder). 
 (d) Until the expiration of one year after the Closing Date, the Company and the Guarantor
will not, and will not permit any of their “affiliates” (as defined in Rule 144) to, resell any of the Securities that have been acquired by any of them except pursuant to an effective registration statement under the Securities Act. 

  
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 4. Registration Expenses. 

The Company and the Guarantors agree to bear and to pay or cause to be paid promptly all expenses incident to the Company’s and the
Guarantors’ performance of or compliance with this Agreement, including, without limitation, (a) all Commission and any FINRA registration, filing and review fees and expenses including fees and disbursements of counsel for the placement
or sales agent or underwriters in connection with such registration, filing and review; (b) all expenses relating to the preparation, printing, production, distribution and reproduction of each registration statement required to be filed
hereunder, each prospectus included therein or prepared for distribution pursuant hereto, each amendment or supplement to the foregoing, the expenses of preparing the Securities for delivery and the expenses of printing or producing any blue sky or
legal investment memoranda and all other documents in connection with the offering, sale or delivery of Securities to be disposed of (including certificates representing the Securities); (c) messenger, telephone and delivery expenses relating
to the offering, sale or delivery of Securities and the preparation of documents referred in clause (b) above; (d) fees and expenses of the Trustee under the Indenture, any agent of the Trustee and any counsel for the Trustee and of any
collateral agent or custodian; (e) internal expenses (including all salaries and expenses of the Company’s or Guarantors’ officers and employees performing legal or accounting duties); (f) fees, disbursements and expenses of
counsel and independent registered public accountants of the Company (including the expenses of any opinions or “comfort” letters required by or incident to such performance and compliance); (g) any fees charged by securities rating
services for rating the Securities; and (h) fees, expenses and disbursements of any other persons, including special experts, retained by the Company or its Guarantors in connection with this Agreement (collectively, the “Registration
Expenses”). To the extent that any reasonable fees are incurred, assumed or paid by any holder of Registrable Securities or its counsel, the Company or its Guarantors shall reimburse such person for the full amount of such reasonable fees so
incurred, assumed or paid promptly after receipt of a request therefor. Notwithstanding the foregoing, the holders of the Registrable Securities being registered shall pay all agency fees and commissions attributable to the sale of such Registrable
Securities. 
 5. Representations and Warranties. 

Each of the Company and the Guarantors, jointly and severally, represents and warrants to, and agrees with, the Initial Purchasers and each of
the holders from time to time of Registrable Securities that: 
 (a) Each registration statement covering Registrable Securities and each
prospectus (including any preliminary or summary prospectus) contained therein or furnished pursuant to Section 3(c) hereof and any further amendments or supplements to any such registration statement or prospectus, when it becomes effective or
is filed with the Commission, as the case may be, will conform in all material respects to the requirements of the Securities Act and the Trust Indenture Act and the rules and regulations of the Commission thereunder and 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 not misleading; and at all times subsequent to the Effective Time when a prospectus would be required to be
delivered under the Securities Act, other than from (i) such time as a notice has been given to holders of Registrable Securities pursuant to Section 3(c)(iii)(F) hereof until (ii) such time as the Company furnishes an amended

  
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or supplemented prospectus pursuant to Section 3(c)(iv) hereof, each such registration statement, and each prospectus (including any summary prospectus) contained therein or furnished
pursuant to Section 3(c) hereof, as then amended or supplemented, will conform in all material respects to the requirements of the Securities Act and the Trust Indenture Act and the rules and regulations of the Commission thereunder and 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 not misleading in the light of the circumstances then existing; provided,
however, that this representation and warranty shall not apply to any statements or omissions made in reliance upon and in conformity with information furnished in writing to the Company by a holder of Registrable Securities expressly for use
therein. 
 (b) Any documents incorporated by reference in any prospectus referred to in Section 5(a) hereof, when they become or
became effective or are or were filed with the Commission, as the case may be, will conform or conformed in all material respects to the requirements of the Securities Act or the Exchange Act, as applicable, and none of such documents will contain
or contained an untrue statement of a material fact or will omit or omitted to state a material fact required to be stated therein or necessary to make the statements therein not misleading; provided, however, that this representation
and warranty shall not apply to any statements or omissions made in reliance upon and in conformity with information furnished in writing to the Company by a holder of Registrable Securities expressly for use therein. 

(c) The compliance by the Company and the Guarantors with all of the provisions of this Agreement and the consummation of the transactions
herein contemplated will not: (i) conflict with or result in a material breach of any of the terms or provisions of, or constitute a default under, any indenture, mortgage, deed of trust, loan agreement or other agreement or instrument to which
the Company or any subsidiary of the Company is a party or by which the Company or any subsidiary of the Company is bound or to which any of the property or assets of the Company or any subsidiary of the Company is subject; (ii) result in any
violation of the provisions of the articles of incorporation, as amended, or the bylaws of the Company; the certificate (or articles) of incorporation, certificate (or articles) of organization, certificate (or articles) of formation or certificate
of limited partnership, as the case may be, and any amendments thereto, of any Guarantor; the bylaws, limited liability company agreement, operating agreement or partnership agreement, as the case may be, and any amendments thereto, of any
Guarantor; or (iii) result in any material violation of any law or statute or any order, rule or regulation of any court or governmental agency or body having jurisdiction over the Company or any subsidiary of the Company or any of their
properties. No consent, approval, authorization, order, registration or qualification of or with any such court or governmental agency or body is required for the consummation by the Company and the Guarantors of the transactions contemplated by
this Agreement, except the registration under the Securities Act of the Securities, the qualification of the Indenture under the Trust Indenture Act and such consents, approvals, authorizations, registrations or qualifications as may be required
under state securities or blue sky laws in connection with the offering and distribution of the Securities. 
 (d) This Agreement has been
duly authorized, executed and delivered by the Company and each Guarantor. 

  
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 6. Indemnification. 

(a) Indemnification by the Company and the Guarantors. The Company and the Guarantors, jointly and severally, will indemnify and hold
harmless each of the holders of Registrable Securities included in an Exchange Registration Statement, and each person who participates as a placement or sales agent or as an underwriter in any offering or sale of such Registrable Securities against
any losses, claims, damages or liabilities, joint or several, to which such holder, agent or underwriter may become subject under the Securities Act or otherwise, insofar as such losses, claims, damages or liabilities (or actions in respect thereof)
arise out of or are based upon an untrue statement or alleged untrue statement of a material fact contained in any Exchange Registration Statement under which such Registrable Securities were registered under the Securities Act, or any preliminary,
final or summary prospectus (including, without limitation, any “issuer free writing prospectus” as defined in Rule 433) contained therein or furnished by the Company to any such holder, agent or underwriter, or any amendment or supplement
thereto, or arise out of or are based upon the omission or alleged omission to state therein a material fact required to be stated therein or necessary to make the statements therein not misleading, and will reimburse such holder, such agent and
such underwriter for any legal or other expenses reasonably incurred by them in connection with investigating or defending any such action or claim as such expenses are incurred; provided, however, that neither the Company nor any
Guarantor shall be liable to any such person in any such case to the extent that any such loss, claim, damage or liability arises out of or is based upon an untrue statement or alleged untrue statement or omission or alleged omission made in any
registration statement contemplated hereunder, or preliminary, final or summary prospectus (including, without limitation, any “issuer free writing prospectus” as defined in Rule 433), or amendment or supplement thereto, in reliance upon
and in conformity with written information furnished to the Company by such person expressly for use therein. 
 (b) Notices of Claims,
Etc. Promptly after receipt by an indemnified party under subsection (a) above of written notice of the commencement of any action, such indemnified party shall, if a claim in respect thereof is to be made against an indemnifying party
pursuant to the indemnification provisions of or contemplated by this Section 6, notify such indemnifying party in writing of the commencement of such action; but the omission so to notify the indemnifying party shall not relieve it from any
liability which it may have to any indemnified party otherwise than under the indemnification provisions of or contemplated by Section 6(a) hereof. In case any such action shall be brought against any indemnified party and it shall notify an
indemnifying party of the commencement thereof, such indemnifying party shall be entitled to participate therein and, to the extent that it shall wish, jointly with any other indemnifying party similarly notified, to assume the defense thereof, with
counsel reasonably satisfactory to such indemnified party (who shall not, except with the consent of the indemnified party, be counsel to the indemnifying party), and, after notice from the indemnifying party to such indemnified party of its
election so to assume the defense thereof, such indemnifying party shall not be liable to such indemnified party for any legal expenses of other counsel or any other expenses, in each case subsequently incurred by such indemnified party, in
connection with the defense thereof other than reasonable costs of investigation. No indemnifying party shall, without the prior written consent of the indemnified party, effect the settlement or compromise of, or consent to the entry of any
judgment with respect to, any pending or threatened action or claim in respect of which indemnification or contribution may be sought hereunder (whether or not the indemnified 

  
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party is an actual or potential party to such action or claim) unless such settlement, compromise or judgment (i) includes an unconditional release of the indemnified party from all
liability arising out of such action or claim and (ii) does not include a statement as to or an admission of fault, culpability or a failure to act by or on behalf of any indemnified party. 

(c) Contribution. If for any reason the indemnification provisions contemplated by Section 6(a) are unavailable to or insufficient
to hold harmless an indemnified party in respect of any losses, claims, damages or liabilities (or actions in respect thereof) referred to therein, then each indemnifying party 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 the relative fault of the indemnifying party and the indemnified party in connection with the statements or
omissions which resulted in such losses, claims, damages or liabilities (or actions in respect thereof), as well as any other relevant equitable considerations. The relative fault of such indemnifying party and indemnified party shall be determined
by reference to, among other things, whether the untrue or alleged untrue statement of a material fact or omission or alleged omission to state a material fact relates to information supplied by such indemnifying party or by such indemnified party,
and the parties’ relative intent, knowledge, access to information and opportunity to correct or prevent such statement or omission. The parties hereto agree that it would not be just and equitable if contributions pursuant to this
Section 6(c) were determined by pro rata allocation (even if the holders or any agents or underwriters or all of them were treated as one entity for such purpose) or by any other method of allocation that does not take account of the equitable
considerations referred to in this Section 6(c). The amount paid or payable by an indemnified party as a result of the losses, claims, damages, or liabilities (or actions in respect thereof) referred to above shall be deemed to include any
legal or other fees or expenses reasonably incurred by such indemnified party in connection with investigating or defending any such action or claim. Notwithstanding the provisions of this Section 6(c), no holder shall be required to contribute
any amount in excess of the amount by which the dollar amount of the proceeds received by such holder from the sale of any Registrable Securities (after deducting any fees, discounts and commissions applicable thereto) exceeds the amount of any
damages that such holder has otherwise been required to pay by reason of such untrue or alleged untrue statement or omission or alleged omission, and no underwriter shall be required to contribute any amount in excess of the amount by which the
total price at which the Registrable Securities underwritten by it and distributed to the public were offered to the public exceeds the amount of any damages that such underwriter has otherwise been required to pay by reason of such untrue or
alleged untrue statement or omission or alleged omission. No person guilty of fraudulent misrepresentation (within the meaning of Section 11(f) of the Securities Act) shall be entitled to contribution from any person who was not guilty of such
fraudulent misrepresentation. The holders’ obligations in this Section 6(c) to contribute shall be several in proportion to the principal amount of Registrable Securities registered by them and not joint. 

(d) The obligations of the Company and the Guarantors under this Section 6 shall be in addition to any liability which the Company or the
Guarantors may otherwise have and shall extend, upon the same terms and conditions, to each officer, director and partner of each holder, agent and underwriter and each person, if any, who controls any holder, agent or underwriter within the meaning
of the Securities Act; and the obligations of the holders and any agents or underwriters contemplated by this Section 6 shall be in addition to any liability which the 

  
 12 

 
respective holder, agent or underwriter may otherwise have and shall extend, upon the same terms and conditions, to each officer and director of the Company or any Guarantor (including any person
who, with his consent, is named in any registration statement as about to become a director of the Company or any Guarantor) and to each person, if any, who controls the Company within the meaning of the Securities Act. 

7. Rule 144. 
 The
Company covenants to the holders of Registrable Securities that to the extent it shall be required to do so under the Exchange Act, the Company shall timely file the reports required to be filed by it under the Exchange Act or the Securities Act
(including the reports under Section 13 and 15(d) of the Exchange Act referred to in subparagraph (c)(1) of Rule 144 adopted by the Commission under the Securities Act) and the rules and regulations adopted by the Commission thereunder, and
shall 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
limitations of the safe harbor provided by Rule 144 under the Securities Act, as such Rule may be amended from time to time, or any similar or successor rule or regulation hereafter adopted by the Commission. Upon the request of any holder of
Registrable Securities in connection with that holder’s sale pursuant to Rule 144, the Company shall deliver to such holder a written statement as to whether it has complied with such requirements. 

8. Miscellaneous. 
 (a)
No Inconsistent Agreements. The Company and each Guarantor represents, warrants, covenants and agrees that it has not granted, and shall not grant, registration rights with respect to Registrable Securities or any other securities which would
be inconsistent with the terms contained in this Agreement. 
 (b) Specific Performance. The parties hereto acknowledge that there
would be no adequate remedy at law if the Company or any Guarantor fails to perform any of its obligations hereunder and that the Initial Purchasers and the holders from time to time of the Registrable Securities may be irreparably harmed by any
such failure, and accordingly agree that the Initial Purchasers and such holders, in addition to any other remedy to which they may be entitled at law or in equity, shall be entitled to seek specific performance of the obligations of the Company and
the Guarantors under this Agreement in accordance with the terms and conditions of this Agreement, in any court of the United States or any state thereof having jurisdiction. 

(c) Notices. All notices, requests, claims, demands, waivers and other communications hereunder shall be in writing and shall be deemed
to have been duly given when delivered by hand, if delivered personally or by courier, or three days after being deposited in the mail (registered or certified mail, postage prepaid, return receipt requested) as follows: If to the Company, to it at
1445 Ross Avenue, Suite 1400, Dallas, Texas 75202, Attention: Paul Castanon, Deputy General Counsel, and if to a holder, to the address of such holder set forth in the security register or other records of the Company, or to such other address as
the Company or any such holder may have furnished to the other in writing in accordance herewith, except that notices of change of address shall be effective only upon receipt. 

  
 13 

 (d) Parties in Interest. All the terms and provisions of this Agreement shall be binding
upon, shall inure to the benefit of and shall be enforceable by the parties hereto and the holders from time to time of the Registrable Securities and the respective successors and assigns of the parties hereto and such holders. In the event that
any transferee of any holder of Registrable Securities shall acquire Registrable Securities, in any manner, whether by gift, bequest, purchase, operation of law or otherwise, such transferee shall, without any further writing or action of any kind,
be deemed a beneficiary hereof for all purposes and such Registrable Securities shall be held subject to all of the terms of this Agreement, and by taking and holding such Registrable Securities such transferee shall be entitled to receive the
benefits of, and be conclusively deemed to have agreed to be bound by all of the applicable terms and provisions of this Agreement. If the Company shall so request, any such successor, assign or transferee shall agree in writing to acquire and hold
the Registrable Securities subject to all of the applicable terms hereof. 
 (e) Survival. The respective indemnities, agreements,
representations, warranties and each other provision set forth in this Agreement or made pursuant hereto shall remain in full force and effect regardless of any investigation (or statement as to the results thereof) made by or on behalf of any
holder of Registrable Securities, any director, officer or partner of such holder, any agent or underwriter or any director, officer or partner thereof, or any controlling person of any of the foregoing, and shall survive delivery of and payment for
the Registrable Securities pursuant to the Purchase Agreement and the transfer and registration of Registrable Securities by such holder and the consummation of an Exchange Offer. 

(f) Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of New
York. 
 (g) Headings. The descriptive headings of the several sections and paragraphs of this Agreement are inserted for
convenience only, do not constitute a part of this Agreement and shall not affect in any way the meaning or interpretation of this Agreement. 

(h) Entire Agreement; Amendments. This Agreement and the other writings referred to herein (including the Indenture, the Purchase
Agreement and the form of Securities) or delivered pursuant hereto which form a part hereof contain the entire understanding of the parties with respect to its subject matter. This Agreement supersedes all prior agreements and understandings between
the parties with respect to its subject matter. This Agreement may be amended and the observance of any term of this Agreement may be waived (either generally or in a particular instance and either retroactively or prospectively) only by a written
instrument duly executed by the Company, the Guarantors and the holders of at least a majority in aggregate principal amount of the Registrable Securities at the time outstanding. Each holder of any Registrable Securities at the time or thereafter
outstanding shall be bound by any amendment or waiver effected pursuant to this Section 8(h), whether or not any notice, writing or marking indicating such amendment or waiver appears on such Registrable Securities or is delivered to such
holder. 
 (i) Inspection. For so long as this Agreement shall be in effect, this Agreement and a complete list of the names and
addresses of all the holders of Registrable Securities shall be made available for inspection and copying on any Business Day by any holder of Registrable 

  
 14 

 
Securities for proper purposes only (which shall include any purpose related to the rights of the holders of Registrable Securities under the Securities, the Indenture and this Agreement) at the
offices of the Company at the address thereof set forth in Section 8(c) above and at the office of the Trustee under the Indenture. 

(j) Counterparts. This Agreement may be executed by the parties in counterparts, each of which shall be deemed to be an original, but
all such respective counterparts shall together constitute one and the same instrument. Delivery of an executed counterpart of a signature page to this Agreement by telecopier, facsimile or other electronic transmission (i.e., a “pdf’ or
“tif’) shall be effective as delivery of a manually executed counterpart thereof. 
 (k) Severability. If any provision of
this Agreement, or the application thereof in any circumstance, is held to be invalid, illegal or unenforceable in any respect for any reason, the validity, legality and enforceability of such provision in every other respect and of the remaining
provisions contained in this Agreement shall not be affected or impaired thereby. 
 (signature pages follow) 

  
 15 

 If the foregoing is in accordance with your understanding, please sign and return to us two
counterparts hereof, and upon the acceptance hereof by you, on behalf of each of the holders, this letter and such acceptance hereof shall constitute a binding agreement among each of the holders, the Guarantors and the Company. 

 

					
	Very truly yours,
	
	TENET HEALTHCARE CORPORATION
		
	By:		 /s/ Tyler C. Murphy

			Name:		Tyler C. Murphy
			Title:		Vice President and Treasurer

  
 [Signature Page to
Exchange and Registration Rights Agreement] 

	
	 AMERICAN MEDICAL (CENTRAL), INC.

	 AMI INFORMATION SYSTEMS GROUP, INC.

	 AMISUB (HEIGHTS), INC.

	 AMISUB (HILTON HEAD), INC.

	 AMISUB (SFH), INC.

	 AMISUB (TWELVE OAKS), INC.

	 AMISUB OF NORTH CAROLINA, INC.

	 AMISUB OF SOUTH CAROLINA, INC.

	 AMISUB OF TEXAS, INC.

	 ANAHEIM MRI HOLDING, INC.

	 ATLANTA MEDICAL CENTER, INC.

	 BROOKWOOD HEALTH SERVICES, INC.

	 CGH HOSPITAL, LTD., by: CORAL GABLES HOSPITALS, INC., as general partner

	 COASTAL CAROLINA MEDICAL CENTER, INC.

	 COMMUNITY HOSPITAL OF LOS GATOS, INC.

	 CORAL GABLES HOSPITAL, INC.

	 CYPRESS FAIRBANKS MEDICAL CENTER, INC.

	 DELRAY MEDICAL CENTER, INC.

	 DES PERES HOSPITAL, INC.

	 DOCTORS HOSPITAL OF MANTECA, INC.

	 DOCTORS MEDICAL CENTER OF MODESTO, INC.

	 EAST COOPER COMMUNITY HOSPITAL, INC.

	 FMC MEDICAL, INC.

	 FOUNTAIN VALLEY REGIONAL HOSPITAL AND MEDICAL CENTER

	 FRYE REGIONAL MEDICAL CENTER, INC.

	 GOOD SAMARITAN MEDICAL CENTER, INC.

	 HEALTHCARE NETWORK CFMC, INC.

	 HEALTHCARE NETWORK HOLDINGS, INC.

	 HEALTHCORP NETWORK, INC.

	 HEALTHCARE NETWORK LOUISIANA, INC.

	 HEALTHCARE NETWORK MISSOURI, INC.

	 HEALTHCARE NETWORK TEXAS, INC.

	 HEALTH SERVICES NETWORK HOSPITALS, INC.

	 HEALTH SERVICES NETWORK TEXAS, INC.

	 HIALEAH HOSPITAL, INC.

	 HILTON HEAD HEALTH SYSTEM, L.P., by: TENET PHYSICIAN SERVICES – HILTON HEAD, INC., as general partner

	 JFK MEMORIAL HOSPITAL, INC.

	 LAKEWOOD REGIONAL MEDICAL CENTER, INC.

	 LIFEMARK HOSPITALS, INC.

	 LIFEMARK HOSPITALS OF FLORIDA, INC.

	 LOS ALAMITOS MEDICAL CENTER, INC.

	 (CONTINUED ON NEXT PAGE)

  
 [Signature Page to
Exchange and Registration Rights Agreement] 

	
	 NEW MEDICAL HORIZONS II, LTD., by: CYPRESS FAIRBANKS MEDICAL CENTER INC., as general partner

	 NORTH FULTON MEDICAL CENTER, INC.

	 NORTH SHORE MEDICAL CENTER, INC.

	 ORNDA HOSPITAL CORPORATION

	 PALM BEACH GARDENS COMMUNITY HOSPITAL, INC.

	 PLACENTIA-LINDA HOSPITAL, INC.

	 SAINT FRANCIS HOSPITAL – BARTLETT, INC.

	 SIERRA VISTA HOSPITAL, INC.

	 SLH VISTA, INC.

	 SPALDING REGIONAL MEDICAL CENTER, INC.

	 SRRMC MANAGEMENT, INC.

	 ST. MARY’S MEDICAL CENTER INC.

	 SYLVAN GROVE HOSPITAL, INC.

	 TENET 100 MEDICAL CENTER SLIDELL, L.L.C, by: HEALTHCARE NETWORK LOUISIANA, INC., as sole and managing member

	 TENET CALIFORNIA, INC.

	 TENET FLORIDA, INC.

	 TENET FRISCO, LTD., by: HEALTHCARE NETWORK TEXAS, INC., as general partner

	 TENET HEALTHSYSTEM HAHNEMANN, L.L.C., by: TENET HEALTHSYSTEM PHILADELPHIA, INC., as managing member

	 TENET HEALTHSYSTEM MEDICAL, INC.

	 TENET HEALTHSYSTEM PHILADELPHIA, INC.

	 TENET HEALTHSYSTEM ST. CHRISTOPHER’S HOSPITAL FOR CHILDREN, L.L.C., by: TENET HEALTHSYSTEM PHILADELPHIA, INC., as managing
member

	 TENET HOSPITALS LIMITED, by: HEALTHCARE NETWORK TEXAS, INC., as general partner

	 TENET PHYSICIAN SERVICES — HILTON HEAD, INC.

	 TH HEALTHCARE, LTD., by: LIFEMARK HOSPITALS, INC., as general partner

	 TWIN CITIES COMMUNITY HOSPITAL, INC.

	 VHS VALLEY MANAGEMENT COMPANY, INC.

	 VHS VALLEY HEALTH SYSTEM, LLC, by: VHS VALLEY MANAGEMENT COMPANY, INC., its sole member

	 VHS BROWNSVILLE HOSPITAL COMPANY, LLC, by: VHS VALLEY HEALTH SYSTEM, LLC, its sole member, by: VHS VALLEY MANAGEMENT COMPANY, INC., its
sole member

	 VHS HARLINGEN HOSPITAL COMPANY, LLC, by: VHS VALLEY HEALTH SYSTEM, LLC, its sole member, by: VHS VALLEY MANAGEMENT COMPANY, INC., its
sole member

	 WEST BOCA MEDICAL CENTER, INC.

	 HOSPITAL DEVELOPMENT OF WEST PHOENIX, INC

	 VHS ACQUISITION CORPORATION

	 VHS ACQUISITION SUBSIDIARY NUMBER 1, INC.

	 VHS ACQUISITION SUBSIDIARY NUMBER 3, INC.

	 VHS ACQUISITION SUBSIDIARY NUMBER 7, INC.

	 (CONTINUED ON NEXT PAGE)

  
 [Signature Page to
Exchange and Registration Rights Agreement] 

	
	 VHS ACQUISITION SUBSIDIARY NUMBER 9, INC.

	 VHS CHILDREN’S HOSPITAL OF MICHIGAN, INC.

	 VHS DETROIT RECEIVING HOSPITAL, INC.

	 VHS HARPER-HUTZEL HOSPITAL, INC.

	 VHS HURON VALLEY-SINAI HOSPITAL, INC.

	 VHS OF ARROWHEAD, INC.

	 VHS OF ILLINOIS, INC.

	 VHS REHABILITATION INSTITUTE OF MICHIGAN, INC.

	 VHS SAN ANTONIO PARTNERS, LLC, by: VHS ACQUISITION SUBSIDIARY NUMBER 5, INC., its managing member, and VHS HOLDING COMPANY,
INC.

	 VHS SINAI-GRACE HOSPITAL, INC.

	 VHS WEST SUBURBAN MEDICAL CENTER, INC.

	 VHS WESTLAKE HOSPITAL INC.

	 VHS OF PHOENIX, INC.

	 VANGUARD HEALTH FINANCIAL COMPANY, LLC

	 VANGUARD HEALTH HOLDING COMPANY I, LLC

	 VANGUARD HEALTH HOLDING COMPANY II, LLC

	 VANGUARD HEALTH MANAGEMENT, INC.

	 VANGUARD HEALTH SYSTEMS, INC.

	 VHS OF MICHIGAN, INC.

  

			
	By:		 /s/ Tyler C. Murphy

		
	Name:		Tyler C. Murphy
		
	Title:		Treasurer

  

			
	DESERT REGIONAL MEDICAL CENTER, INC.
	DOCTORS MEDICAL CENTER OF MODESTO, INC.		
	LOS ALAMITOS MEDICAL CENTER, INC.		
	 SAN RAMON REGIONAL MEDICAL CENTER, LLC (as successor by merger to SAN RAMON REGIONAL MEDICAL CENTER, INC.)
		

  

			
	By:		 /s/ James E. Snyder, III

		
	Name:		James E. Snyder, III
	Title:		Assistant Treasurer

  
 [Signature Page to
Exchange and Registration Rights Agreement] 

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

 

					
	BARCLAYS CAPITAL INC.
	(on behalf of the holders)
		
	By:		 /s/ John Skrobe

			Name:		John Skrobe
			Title:		Managing Director

  
 [Signature Page to
Exchange and Registration Rights Agreement] 

 Schedule I 

Guarantors 
 American Medical (Central),
Inc. 
 AMI Information Systems Group, Inc. 
 Amisub (Heights),
Inc. 
 Amisub (Hilton Head), Inc. 
 Amisub (SFH), Inc. 

Amisub (Twelve Oaks), Inc. 
 Amisub of North Carolina, Inc. 

Amisub of South Carolina, Inc. 
 Amisub of Texas, Inc. 

Anaheim MRI Holding, Inc. (formerly known as USC University Hospital, Inc. and formerly known as Tenet 1500 San Pablo, Inc.) 

Atlanta Medical Center, Inc. 
 Brookwood Health Services, Inc.

 CGH Hospital, Ltd. 
 Coastal Carolina Medical Center, Inc.

 Community Hospital of Los Gatos, Inc. 
 Coral Gables
Hospital, Inc. 
 Cypress Fairbanks Medical Center, Inc. 

Delray Medical Center, Inc. 
 Des Peres Hospital, Inc. 

Desert Regional Medical Center, Inc. 
 Doctors Hospital of
Manteca, Inc. 
 Doctors Medical Center of Modesto, Inc. 
 East
Cooper Community Hospital, Inc. 
 FMC Medical, Inc. 
 Fountain
Valley Regional Hospital and Medical Center 
 Frye Regional Medical Center, Inc. 

Good Samaritan Medical Center, Inc. 
 Health Services Network
Hospitals, Inc. 
 Health Services Network Texas, Inc. 

Healthcare Network CFMC, Inc. 
 Healthcare Network Holdings, Inc.

 Healthcare Network Louisiana, Inc. 
 Healthcare Network
Missouri, Inc. 
 Healthcare Network Texas, Inc. 
 HealthCorp
Network, Inc. 
 Hialeah Hospital, Inc. 
 Hilton Head Health
System, L.P. 
 Hospital Development of West Phoenix, Inc. 
 JFK
Memorial Hospital, Inc. 
 Lakewood Regional Medical Center, Inc. 

 Lifemark Hospitals of Florida, Inc. 

Lifemark Hospitals, Inc. 
 Los Alamitos Medical Center, Inc. 

New Medical Horizons II, Ltd. 
 North Fulton Medical Center, Inc.

 North Shore Medical Center, Inc. 
 OrNda Hospital Corporation

 Palm Beach Gardens Community Hospital, Inc. 
 Placentia-Linda
Hospital, Inc. 
 Saint Francis Hospital – Bartlett, Inc. 

San Ramon Regional Medical Center, LLC 
 Sierra Vista Hospital,
Inc. 
 SLH Vista, Inc. 
 Spalding Regional Medical Center, Inc.

 SRRMC Management, Inc. 
 St. Mary’s Medical Center Inc.

 Sylvan Grove Hospital, Inc. 
 Tenet 100 Medical Center
Slidell, L.L.C. (formerly known as NorthShore Regional Medical Center, L.L.C.) 
 Tenet California, Inc. 

Tenet Florida, Inc. 
 Tenet Frisco, Ltd. 

Tenet HealthSystem Hahnemann, L.L.C. 
 Tenet HealthSystem Medical,
Inc. 
 Tenet HealthSystem Philadelphia, Inc. 
 Tenet
HealthSystem St. Christopher’s Hospital for Children, L.L.C. 
 Tenet Hospitals Limited 

Tenet Physician Services — Hilton Head, Inc. 
 TH Healthcare,
Ltd. 
 Twin Cities Community Hospital, Inc. 
 Vanguard Health
Financial Company, LLC 
 Vanguard Health Holding Company I, LLC 

Vanguard Health Holding Company II, LLC 
 Vanguard Health
Management, Inc. 
 Vanguard Health Systems, Inc. 
 VHS
Acquisition Corporation 
 VHS Acquisition Subsidiary Number 1, Inc. 

VHS Acquisition Subsidiary Number 3, Inc. 
 VHS Acquisition
Subsidiary Number 7, Inc. 
 VHS Acquisition Subsidiary Number 9, Inc. 

VHS Brownsville Hospital Company, LLC 
 VHS Children’s
Hospital of Michigan, Inc. 
 VHS Detroit Receiving Hospital, Inc. 

VHS Harlingen Hospital Company, LLC 
 VHS Harper-Hutzel Hospital,
Inc. 
 VHS Huron Valley-Sinai Hospital, Inc. 

 VHS of Arrowhead, Inc. 

VHS of Illinois, Inc. 
 VHS of Michigan, Inc. 

VHS of Phoenix, Inc. 
 VHS Rehabilitation Institute of Michigan,
Inc. 
 VHS San Antonio Partners, LLC 
 VHS Sinai-Grace
Hospital, Inc. 
 VHS Valley Health System, LLC 
 VHS Valley
Management Company, Inc. 
 VHS West Suburban Medical Center, Inc. 

VHS Westlake Hospital, Inc. 
 West Boca Medical Center, Inc.EX-10.2

 Exhibit 10.2 

EXCHANGE AND REGISTRATION RIGHTS AGREEMENT 

Dated as of June 16, 2015 
 by
and among 
 Tenet Healthcare Corporation 

and 
 Barclays Capital Inc. 

As Representative of the Initial Purchasers 

This Exchange and Registration Rights Agreement (this “Agreement”) is made and entered into as of June 16, 2015,
by and among Tenet Healthcare Corporation, a Nevada corporation (the “Company”), and Barclays Capital Inc., as representative (the “Representative”) of the several Initial Purchasers (as defined
herein). Each of the Initial Purchasers has agreed to purchase THC Escrow Corporation II’s (the “Escrow Issuer”) 6.75% Senior Notes due 2023 (the “Initial Notes”), which will be assumed by the
Company on the date hereof, pursuant to the Purchase Agreement, dated June 2, 2015, by and among the Escrow Issuer, the Company and the Representative (the “Purchase Agreement”). 

In order to induce the Initial Purchasers to purchase the Initial Notes, the Company has agreed to provide the registration rights set forth
in this Agreement. The execution and delivery of this Agreement is a condition to the obligations of the Initial Purchasers under the Purchase Agreement. Capitalized terms used herein and not otherwise defined shall have the meaning assigned to them
in the Indenture, relating to the Initial Notes and the Exchange Notes (as defined below). 
 The parties hereby agree as follows: 

SECTION 1. DEFINITIONS 
 As used in this
Agreement, the following capitalized terms shall have the following meanings: 
 Affiliate shall have the meaning set
forth in Rule 144 of the Securities Act. 
 Base Interest shall mean the interest that would otherwise accrue on the
Notes under the terms thereof and the Indenture, without giving effect to the provisions of this Agreement. 

Broker-Dealer shall mean any broker or dealer registered with the Commission under the Exchange Act. 

Business Day shall mean each Monday, Tuesday, Wednesday, Thursday and Friday that is not a day on which banking
institutions in New York City are authorized or obligated by law or executive order to close. 
 Closing Date shall mean
the date on which the Initial Notes are initially issued. 

 Commission shall mean the United States Securities and Exchange Commission or
any other federal agency at the time administering the Exchange Act or the Securities Act, whichever is the relevant statute for the particular purpose. 

Consummate: an Exchange Offer shall be deemed “Consummated” for purposes of this Agreement upon the occurrence of
(a) the filing and effectiveness under the Securities Act of the Exchange Offer Registration Statement relating to the Exchange Notes to be issued in the Exchange Offer, (b) the maintenance of such Exchange Offer Registration Statement
continuously effective and the keeping of the Exchange Offer open for a period not less than the period required pursuant to Section 3(b) hereof and (c) the delivery by the Company to the Registrar under the Indenture of Exchange Notes in
the same aggregate principal amount as the aggregate principal amount of Initial Notes validly tendered by Holders thereof and accepted by the Company pursuant to the Exchange Offer. 

Consummation Deadline shall have the meaning set forth in Section 3(b) hereof. 

Effectiveness Deadline shall have the meanings set forth in Section 4(a) hereof. 

Exchange Act shall mean the Securities Exchange Act of 1934, or any successor thereto, as the same may be amended from time
to time. 
 Exchange Notes shall mean the Company’s 6.75% Senior Notes due 2023, to be issued pursuant to the
Indenture (i) in the Exchange Offer or (ii) as contemplated by Section 4 hereof. 
 Exchange Offer shall
mean the exchange and issuance by the Company of a principal amount of Exchange Notes (which shall be registered pursuant to the Exchange Offer Registration Statement) equal to the outstanding principal amount of Initial Notes that are validly
tendered by Holders and accepted by the Company in connection with such exchange and issuance. 
 Exchange Offer Registration
Statement shall mean the Registration Statement relating to the Exchange Offer, including the related Prospectus. 

Exempt Resales shall mean the transactions in which the Initial Purchasers propose to sell the Initial Notes to certain
“qualified institutional buyers,” as such term is defined in Rule 144A under the Securities Act and pursuant to Regulation S under the Securities Act. 

Filing Date shall mean the date of the filing of the Exchange Offer Registration Statement or the Shelf Registration
Statement, as the case may be, with the Commission. 
 Filing Deadline shall have the meanings set forth in
Section 4(a) hereof. 
 Holders shall have the meaning set forth in Section 2 hereof. 

Indemnified Party shall have the meaning set forth in Section 8(c) hereof. 

Indemnifying Party shall have the meaning set forth in Section 8(c) hereof. 

Indenture shall mean the Indenture, dated the Closing Date, between the Escrow Issuer and the Trustee, as supplemented by
the Supplemental Indenture, dated as of the date hereof, between the Company and the Trustee, as the same shall be supplemented or amended from time to time. 

  
 2 

 Initial Purchasers shall mean Barclays Capital Inc., Citigroup Global Markets Inc.,
Deutsche Bank Securities Inc., Goldman, Sachs & Co., RBC Capital Markets, LLC and SunTrust Robinson Humphrey, Inc. 

Notes shall mean, collectively, the Initial Notes to be issued and sold to the Initial Purchasers, and securities issued in
exchange therefore or in lieu thereof pursuant to the Indenture. 
 Offering Memorandum shall mean the offering memorandum,
dated as of June 2, 2015, prepared in connection with the offer and sale of the Initial Notes. 
 Prospectus shall
mean the prospectus included in a Registration Statement at the time such Registration Statement is declared effective, as amended or supplemented by any prospectus supplement and by all other amendments thereto, including post-effective amendments,
and all material incorporated by reference into such Prospectus. 
 Recommencement Date shall have the meaning set forth
in Section 6(d) hereof. 
 Registration Default shall have the meaning set forth in Section 5 hereof. 

Registration Statement shall mean any registration statement of the Company relating to (a) an offering of Exchange
Notes pursuant to an Exchange Offer or (b) the registration for resale of Transfer Restricted Securities pursuant to the Shelf Registration Statement, in each case, (i) that is filed pursuant to the provisions of this Agreement and
(ii) including the Prospectus included therein, all amendments and supplements thereto (including post-effective amendments) and all exhibits and material incorporated by reference therein. 

Rule 144 shall mean Rule 144 promulgated under the Securities Act. 

Securities Act shall mean the Securities Act of 1933, or any successor thereto, as the same may be amended from time to
time. 
 Shelf Registration Statement shall have the meaning set forth in Section 4 hereof. 

Special Interest shall have the meaning set forth in Section 5 hereof. 

Suspension Notice shall have the meaning set forth in Section 6(d) hereof. 

TIA shall mean the Trust Indenture Act of 1939 (15 U.S.C. Section 77aaa-77bbbb) as in effect on the date of the
Indenture. 
 Transfer Restricted Securities shall mean (a) each Initial Note, until the earliest to occur of
(i) the date on which such Initial Note is exchanged in the Exchange Offer for an Exchange Note which is entitled to be resold to the public by the Holder thereof without complying with the prospectus delivery requirements of the Securities
Act, (ii) the date on which such Initial Note has been disposed of in accordance with a Shelf Registration Statement (and the purchasers thereof have been issued Exchange Notes), or (iii) the date on which such Initial Note is sold
pursuant to Rule 144 under the Securities Act and (b) each Exchange Note held by a Broker-Dealer 

  
 3 

 
until the date on which such Exchange Note is disposed of by a Broker-Dealer pursuant to the “Plan of Distribution” contemplated by the Exchange Offer Registration Statement (including
the delivery of the Prospectus contained therein). 
 SECTION 2. HOLDERS 

A Person is deemed to be a holder of Transfer Restricted Securities (each, a “Holder”) whenever such Person owns
Transfer Restricted Securities. 
 SECTION 3. REGISTERED EXCHANGE OFFER 

(a) Unless the Exchange Offer shall not be permitted by applicable federal law (after the procedures set forth in
Section 6(a)(i) below have been complied with) or the policies, rules or regulations of the Commission, the Company shall (i) cause the Exchange Offer Registration Statement to be filed with the Commission, (ii) use its
commercially reasonable efforts to cause such Exchange Offer Registration Statement to become effective at the earliest possible time, (iii) in connection with the foregoing, (A) file all pre-effective amendments to such Exchange Offer
Registration Statement as may be necessary in order to cause it to become effective, (B) file, if applicable, a post-effective amendment to such Exchange Offer Registration Statement pursuant to Rule 430A under the Securities Act and
(C) cause all necessary filings, if any, in connection with the registration and qualification of the Exchange Notes to be made under the Blue Sky laws of such jurisdictions as are necessary to permit Consummation of the Exchange Offer, and
(iv) as soon as practicable following the effectiveness of such Exchange Offer Registration Statement, use its commercially reasonable efforts to commence and Consummate the Exchange Offer, but in no event later than 270 days after the date
hereof. The Exchange Offer shall be on the appropriate form permitting (i) registration of the Exchange Notes to be offered in exchange for the Initial Notes that are Transfer Restricted Securities and (ii) resales of Exchange Notes by
Broker-Dealers that tendered into the Exchange Offer Initial Notes that such Broker-Dealer acquired for its own account as a result of market making activities or other trading activities (other than Initial Notes acquired directly from the Company
or any of its Affiliates) as contemplated by Section 3(c) below. 
 (b) The Company shall use its commercially reasonable efforts
to cause the Exchange Offer Registration Statement to be effective continuously, and shall keep the Exchange Offer open for a period of not less than the minimum period required under applicable federal and state securities laws to Consummate the
Exchange Offer; provided, however, that in no event shall such period be less than 20 Business Days. The Company shall cause the Exchange Offer to comply with all applicable federal and state securities laws. No securities other
than the Exchange Notes shall be included in the Exchange Offer Registration Statement. The Company shall use its commercially reasonable efforts to cause the Exchange Offer to be Consummated on the earliest practicable date after the Exchange Offer
Registration Statement has become effective but in no event later than 30 Business Days thereafter, unless required by applicable law or the policies, rules or regulations of the Commission (the last day of such period being the
“Consummation Deadline”). 
 (c) The Company shall include a “Plan of Distribution” section in the
Prospectus contained in the Exchange Offer Registration Statement and indicate therein that any Broker-Dealer who holds Transfer Restricted Securities that were acquired for the account of such Broker-Dealer as a result of market-making activities
or other trading activities (other than Initial Notes acquired 

  
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directly from the Company or any Affiliate of the Company), may exchange such Transfer Restricted Securities pursuant to the Exchange Offer. Such “Plan of Distribution” section shall
also contain all other information with respect to such sales by such Broker-Dealers that the Commission may require in order to permit such sales pursuant thereto, but such “Plan of Distribution” shall not name any such Broker-Dealer or
disclose the amount of Transfer Restricted Securities held by any such Broker-Dealer, except to the extent required by the Commission as a result of a change in policy, rules or regulations after the date of this Agreement. 

Because such Broker-Dealer may be deemed to be an “underwriter” within the meaning of the Securities Act and must, therefore,
deliver a prospectus meeting the requirements of the Securities Act in connection with its initial sale of any Exchange Notes received by such Broker-Dealer in the Exchange Offer, the Company shall permit the use of the Prospectus contained in the
Exchange Offer Registration Statement by such Broker-Dealer to satisfy such prospectus delivery requirement. To the extent necessary to ensure that the Prospectus contained in the Exchange Offer Registration Statement is available for sales of
Exchange Notes by Broker-Dealers, the Company agrees to use its commercially reasonable efforts to keep the Exchange Offer Registration Statement continuously effective, supplemented, amended and current as required by and subject to the provisions
of Section 6(a) and (c) hereof and in conformity with the requirements of this Agreement, the Securities Act and the policies, rules and regulations of the Commission as announced from time to time, for a period of 180 days from the
Consummation Deadline or such shorter period as will terminate when all Transfer Restricted Securities covered by such Registration Statement have been sold pursuant thereto. The Company shall provide sufficient copies of the latest version of such
Prospectus to such Broker-Dealers, promptly upon request, and in no event later than two Business Days after such request, at any time during such period. 

SECTION 4. SHELF REGISTRATION 

(a) Shelf Registration. If (i) the Exchange Offer is not permitted by applicable law (after the Company has complied with the
procedures set forth in Section 6(a)(i) below) or the policies, rules or regulations of the Commission or (ii) for any reason the Exchange Offer is not Consummated by the Consummation Deadline or (iii) if any Holder of Transfer
Restricted Securities shall notify the Company within 20 Business Days following the Consummation of the Exchange Offer that (A) such Holder was prohibited by applicable law or the policies, rules or regulations of the Commission from
participating in the Exchange Offer; or (B) such Holder may not resell the Exchange Notes acquired by it in the Exchange Offer to the public without delivering a prospectus and the Prospectus contained in the Exchange Offer Registration
Statement is not appropriate or available for such resales by such Holder; or (C) such Holder is a Broker-Dealer and holds Initial Notes acquired directly from the Company or any of its Affiliates, then the Company shall: 

(x) file, on or prior to 30 days after the earlier of (i) the date on which the Company determines that the
Exchange Offer Registration Statement cannot be filed as a result of clause (a)(i) above, (ii) the next Business Day following the Consummation Deadline, if the Exchange Offer is not Consummated by the Consummation Deadline and
(iii) the date on which the Company receives the notice specified in clause (a)(iii) above (such earlier date, the “Filing Deadline”), a shelf registration 

  
 5 

 
statement pursuant to Rule 415 under the Securities Act (which may be an amendment to the Exchange Offer Registration Statement (the “Shelf Registration Statement”)),
relating to all Transfer Restricted Securities, and 
 (y) shall use its commercially reasonable efforts to cause such
Shelf Registration Statement to become effective on or prior to 90 days after the Filing Date (such 90th day, the “Effectiveness Deadline”). 

If, after the Company has filed an Exchange Offer Registration Statement that satisfies the requirements of Section 3(a) above, the
Company is required to file and make effective a Shelf Registration Statement solely because the Exchange Offer is not permitted under applicable law or the policies, rules or regulations of the Commission (i.e., as contemplated by
clause (a)(i) above), then the filing of the Exchange Offer Registration Statement shall be deemed to satisfy the requirements of clause (x) above; provided that, in such event, the Company shall remain obligated to
meet the Effectiveness Deadline set forth in clause (y). 
 To the extent necessary to ensure that the Shelf Registration Statement is
available for sales of Transfer Restricted Securities by the Holders thereof entitled to the benefit of this Section 4(a) and the other securities required to be registered therein pursuant to Section 6(b)(ii) hereof, the Company
shall use its commercially reasonable efforts to keep any Shelf Registration Statement required by this Section 4(a) continuously effective, supplemented, amended and current as required by and subject to the provisions of Sections 6(b) and
(c) hereof and in conformity with the requirements of this Agreement, the Securities Act and the policies, rules and regulations of the Commission as announced from time to time, for a period of at least two years (as extended pursuant to
Section 6(c)(i)) following the Closing Date, or such shorter period as will terminate when all Transfer Restricted Securities covered by such Shelf Registration Statement have been sold pursuant thereto. 

(b) Provision by Holders of Certain Information in Connection with the Shelf Registration Statement. No Holder of Transfer
Restricted Securities may include any of its Transfer Restricted Securities in any Shelf Registration Statement pursuant to this Agreement unless and until such Holder furnishes to the Company in writing, within 20 days after receipt of a
request therefor, the information specified in Item 507 or Item 508 of Regulation S-K, as applicable, of the Securities Act for use in connection with any Shelf Registration Statement or Prospectus or preliminary Prospectus included
therein and such other information as the Company may reasonably request. No Holder of Transfer Restricted Securities shall be entitled to Special Interest pursuant to Section 5 hereof relating to a Shelf Registration Statement unless and until
such Holder shall have provided all such information. Each selling Holder agrees to promptly furnish additional information required to be disclosed in order to make the information previously furnished to the Company by such Holder not materially
misleading. 
 SECTION 5. SPECIAL INTEREST 

If (i) any Registration Statement required by this Agreement is not filed with the Commission on or prior to the applicable Filing
Deadline, (ii) any such Registration Statement has not been declared effective by the Commission on or prior to the applicable Effectiveness Deadline, (iii) the Exchange Offer has not been Consummated on or prior to the Consummation
Deadline or (iv) any Registration Statement required by this Agreement is filed and declared effective but shall thereafter cease to be effective or fail to be usable for its intended purpose 

  
 6 

 
without being succeeded by a post-effective amendment to such Registration Statement that cures such failure and that is itself declared effective promptly (each such event referred to in clauses
(i) through (iv), a “Registration Default”), then the Company hereby agrees to pay to each Holder of Transfer Restricted Securities affected thereby, as liquidated damages for such Registration Default, special interest
(“Special Interest”), in addition to the Base Interest, which Special Interest shall accrue at a per annum rate of 0.25% for the first 90-day period immediately following the occurrence of such Registration Default, at a per
annum rate of 0.50% for the second 90-day period following the occurrence of such Registration Default, at a per annum rate of 0.75% for the third 90-day period following the occurrence of such Registration Default and at a per annum rate of 1.0%
thereafter for any remaining time period until all Registration Defaults have been cured; provided that the Company shall in no event be required to pay Special Interest for more than one Registration Default at any given time.
Notwithstanding anything to the contrary set forth herein, (1) upon filing of the Exchange Offer Registration Statement (and/or, if applicable, the Shelf Registration Statement), in the case of (i) above, (2) upon the effectiveness of
the Exchange Offer Registration Statement (and/or, if applicable, the Shelf Registration Statement), in the case of (ii) above, (3) upon Consummation of the Exchange Offer, in the case of (iii) above, or (4) upon the filing of a
post-effective amendment to the Registration Statement or an additional Registration Statement that causes the Exchange Offer Registration Statement (and/or, if applicable, the Shelf Registration Statement) to again be declared effective or made
usable in the case of (iv) above, the Special Interest payable with respect to the Transfer Restricted Securities as a result of such clause (i), (ii), (iii) or (iv), as applicable, shall cease. 

All accrued Special Interest shall be paid to the Holders entitled thereto, in the manner provided for the payment of interest in the
Indenture, on each Interest Payment Date, as more fully set forth in the Indenture and the Notes. Notwithstanding the fact that any securities for which Special Interest is due cease to be Transfer Restricted Securities, all obligations of the
Company to pay Special Interest with respect to such securities shall survive until such time as such obligations with respect to such securities shall have been satisfied in full. Notwithstanding anything contained herein or in the Indenture to the
contrary, the payment of Special Interest shall be the only remedy available to Holders for any Registration Default. 
 SECTION 6. REGISTRATION
PROCEDURES 
 (a) Exchange Offer Registration Statement. In connection with the Exchange Offer, the Company shall
(x) comply with all applicable provisions of Section 6(c) below, (y) use its commercially reasonable efforts to effect such exchange and to permit the resale of Exchange Notes by Broker-Dealers that validly tendered, in the Exchange
Offer, Initial Notes that such Broker-Dealer acquired for its own account as a result of its market making activities or other trading activities (other than Initial Notes acquired directly from the Company or any of its Affiliates) being sold in
accordance with the intended method or methods of distribution thereof, and (z) comply with all of the following provisions: 

(i) If, following the date hereof there has been announced a change in the policies, rules or regulations of the
Commission with respect to exchange offers such as the Exchange Offer, that in the reasonable opinion of counsel to the Company raises a substantial question as to whether the Exchange Offer is permitted by applicable law, the Company hereby agrees
to use commercially reasonable efforts to seek a no-action letter or other favorable decision from the Commission allowing the Company to 

  
 7 

 
Consummate an Exchange Offer for such Transfer Restricted Securities. In connection with the foregoing, the Company hereby agrees to take such other commercially reasonable actions as may be
requested by the Commission or otherwise required in connection with the issuance of such decision, including without limitation (A) participating in telephonic conferences with the Commission, (B) delivering to the Commission staff an
analysis prepared by counsel to the Company setting forth the legal bases, if any, upon which such counsel has concluded that such an Exchange Offer should be permitted and (C) diligently pursuing a resolution (which need not be favorable) by
the Commission staff. 
 (ii) As a condition to its participation in the Exchange Offer, each Holder of Transfer
Restricted Securities (including, without limitation, any Holder who is a Broker-Dealer) shall furnish, upon the request of the Company, prior to the Consummation of the Exchange Offer, a written representation to the Company (which may be contained
in the letter of transmittal contemplated by the Exchange Offer Registration Statement) to the effect that (A) it is not an Affiliate of the Company, (B) it is not engaged in, and does not intend to engage in, and has no arrangement or
understanding with any person to participate in, a distribution of the Exchange Notes to be issued in the Exchange Offer and (C) it is acquiring the Exchange Notes in its ordinary course of business. As a condition to its participation in the
Exchange Offer, each Holder using the Exchange Offer to participate in a distribution of the Exchange Notes hereby acknowledges and agrees that, if the resales are of Exchange Notes obtained by such Holder in exchange for Initial Notes acquired
directly from the Company or an Affiliate thereof, it (1) could not, under the policies, rules or regulations of the Commission as in effect on the date of this Agreement, rely on the position of the Commission enunciated in Morgan
Stanley and Co. Inc. (available June 5, 1991) and Exxon Capital Holdings Corporation (available May 13, 1988), as interpreted in the Commission’s letter to Shearman &
Sterling dated July 2, 1993, and similar no-action letters (including, if applicable, any no-action letter obtained pursuant to clause (i) above), and (2) must comply with the registration and prospectus delivery requirements
of the Securities Act in connection with a secondary resale transaction and that such a secondary resale transaction must be covered by an effective registration statement containing the selling security holder information required by Item 507
or 508, as applicable, of Regulation S-K. 
 (iii) Prior to effectiveness of the Exchange Offer Registration
Statement, the Company shall provide a supplemental letter to the Commission (A) stating that the Company is registering the Exchange Offer in reliance on the position of the Commission enunciated in Exxon Capital Holdings
Corporation (available May 13, 1988), Morgan Stanley and Co. Inc. (available June 5, 1991) as interpreted in the Commission’s letter to Shearman & Sterling dated July 2,
1993, and, if applicable, any no-action letter obtained pursuant to clause (i) above, (B) including a representation that the Company has not entered into any arrangement or understanding with any Person to distribute the Exchange Notes to
be received in the Exchange Offer and that, to the best of the Company’s information and belief, each Holder participating in the Exchange Offer is acquiring the Exchange Notes in its ordinary course of business and has no arrangement or
understanding with any Person to participate in the distribution 

  
 8 

 
of the Exchange Notes received in the Exchange Offer and (C) providing any other commercially reasonable undertaking or representation required by the Commission as set forth in any
no-action letter obtained pursuant to clause (i) above, if applicable. 
 (b) Shelf Registration Statement. In connection
with the Shelf Registration Statement, if any, the Company shall: 
 (i) (x) comply with all the provisions of
Section 6(c) below and (y) use its commercially reasonable efforts to effect such registration to permit the sale of the Transfer Restricted Securities being sold in accordance with the intended method or methods of distribution thereof
(as indicated in the information furnished to the Company pursuant to Section 4(b) hereof), and pursuant thereto the Company will prepare and file with the Commission a Registration Statement relating to the registration on any appropriate form
under the Securities Act, which form shall be available for the sale of the Transfer Restricted Securities in accordance with the intended method or methods of distribution thereof within the time periods and otherwise in accordance with the
provisions hereof; and 
 (ii) issue, subject to compliance with the applicable Indenture, upon the request of any
Holder or purchaser of Initial Notes covered by any Shelf Registration Statement contemplated by this Agreement, Exchange Notes having an aggregate principal amount equal to the aggregate principal amount of Initial Notes sold pursuant to the Shelf
Registration Statement and surrendered to the Company for cancellation; the Company shall register Exchange Notes on the Shelf Registration Statement for this purpose and issue the Exchange Notes to the purchaser(s) of securities subject to the
Shelf Registration Statement in the names as such purchaser(s) shall designate; provided, that the Holder shall pay any transfer taxes or other fees charged in connection with such registration of Exchange Notes. 

(c) General Provisions. In connection with any Registration Statement and any related Prospectus required by this Agreement, the
Company shall: 
 (i) use its commercially reasonable efforts to keep such Registration Statement continuously effective
and provide all requisite financial statements for the period specified in Section 3 or 4 of this Agreement, as applicable. Upon the occurrence of any event that would cause any such Registration Statement (A) to contain an untrue
statement of material fact or omit to state any material fact required to be stated therein or necessary to make the statements therein not misleading or (B) not to be effective and usable for resale of Transfer Restricted Securities during the
period required by this Agreement, the Company shall use its commercially reasonable efforts to file promptly an appropriate amendment to such Registration Statement curing such defect, and, if Commission review is required, use its commercially
reasonable efforts to cause such amendment to be declared effective as soon as practicable; 
 (ii) use its commercially
reasonable efforts to prepare and file with the Commission such amendments and post-effective amendments to the applicable Registration Statement as may be necessary to keep such Registration Statement effective for the applicable period set forth
in Section 3 or 4 hereof, as the case may be; cause the Prospectus to be supplemented by any required Prospectus supplement, and 

  
 9 

 
as so supplemented to be filed pursuant to Rule 424 under the Securities Act, and to comply fully with Rules 424, 430A and 462, as applicable, under the Securities Act in a timely
manner; and comply with the provisions of the Securities Act in connection with the disposition of all securities covered by such Registration Statement during the applicable period in accordance with the intended method or methods of distribution
by the sellers thereof set forth in such Registration Statement or supplement to the Prospectus; 
 (iii) advise each
Holder promptly and, if requested by such Holder, confirm such advice in writing, (A) when the Prospectus or any Prospectus supplement or post-effective amendment has been filed, and, with respect to any applicable Registration Statement or any
post-effective amendment thereto, when the same has become effective, (B) of any request by the Commission for amendments to the Registration Statement or amendments or supplements to the Prospectus or for additional information relating
thereto, (C) of the issuance by the Commission of any stop order suspending the effectiveness of the Registration Statement under the Securities Act or of the suspension by any state securities commission of the qualification of the Transfer
Restricted Securities for offering or sale in any jurisdiction, or the initiation of any proceeding for any of the preceding purposes, (D) of the existence of any fact or the happening of any event that makes any statement of a material fact
made in the Registration Statement, the Prospectus, any amendment or supplement thereto or any document incorporated by reference therein untrue, or that requires the making of any additions to or changes in the Registration Statement in order to
make the statements therein not misleading, or that requires the making of any additions to or changes in the Prospectus in order to make the statements therein, in the light of the circumstances under which they were made, not misleading. If at any
time the Commission shall issue any stop order suspending the effectiveness of the Registration Statement, or any state securities commission or other regulatory authority shall issue an order suspending the qualification or exemption from
qualification of the Transfer Restricted Securities under state securities or Blue Sky laws, the Company shall use its commercially reasonable efforts to obtain the withdrawal or lifting of such order at the earliest possible time; 

(iv) subject to Section 6(c)(i), if any fact or event contemplated by Section 6(c)(iii)(D) above shall exist or
have occurred, use commercially reasonable efforts to prepare a supplement or post-effective amendment to the Registration Statement or related Prospectus or any document incorporated therein by reference or file any other required document so that,
as thereafter delivered to the purchasers of Transfer Restricted Securities, the Prospectus will not contain an untrue statement of a material fact or omit to state any material fact necessary to make the statements therein, in the light of the
circumstances under which they were made, not misleading; 
 (v) if requested by an Initial Purchaser or a Holder,
furnish to each Holder in connection with such exchange or sale, if any, before filing with the Commission, copies of any Registration Statement or any Prospectus included therein or any amendments or supplements to any such Registration Statement
or Prospectus (including all documents incorporated by reference after the initial filing of such Registration Statement), which documents will be subject to the review and comment 

  
 10 

 
of such Holders in connection with such sale, if any, for a period of at least five Business Days if practicable, or such shorter time period as is practicable, and the Company will not file any
such Registration Statement or Prospectus or any amendment or supplement to any such Registration Statement or Prospectus (including all such documents incorporated by reference) to which such Holders shall reasonably object within five Business
Days after the receipt thereof. A Holder shall be deemed to have reasonably objected to such filing only if such Registration Statement, amendment, Prospectus or supplement, as applicable, as proposed to be filed, contains an untrue statement of a
material fact or omits to state any material fact necessary to make the statements therein not misleading or fails to comply with the applicable requirements of the Securities Act; 

(vi) make available, at reasonable times, for inspection by one Holder designated by a majority of the Holders and any
attorney or accountant retained by such Holders, all financial and other records, pertinent corporate documents of the Company and cause the Company’s officers, directors and employees to supply all information reasonably requested by any such
Holder, attorney or accountant in connection with such Registration Statement or any post-effective amendment thereto subsequent to the filing thereof and prior to its effectiveness; provided, however, that any information that is
designated in writing by the Company as confidential at the time of delivery of such information shall be kept confidential by the Holders or any such attorney or accountant, unless such disclosure is required by law; 

(vii) if requested by any Holders in connection with such exchange or sale, promptly include in any Registration Statement
or Prospectus, pursuant to a supplement or post-effective amendment if necessary, such information as such Holders may reasonably request to have included therein, including, without limitation, information relating to the “Plan of
Distribution” of the Transfer Restricted Securities; provided, that the Company shall not be required to participate in a distribution of any derivative security by or on behalf of any Holder; and make all required filings of such
Prospectus supplement or post-effective amendment as soon as practicable after the Company is notified of the matters to be included in such Prospectus supplement or post-effective amendment; 

(viii) deliver to each Holder without charge, as many copies of the Prospectus (including each preliminary prospectus) and
any amendment or supplement thereto as such Persons reasonably may request; the Company hereby consents to the use (in accordance with law) of the Prospectus and any amendment or supplement thereto by each selling Holder in connection with the
offering and the sale of the Transfer Restricted Securities covered by the Prospectus or any amendment or supplement thereto; 

  
 11 

 (ix) upon the request of any Holder, enter into such commercially reasonable
agreements (including underwriting agreements) and make such customary representations and warranties and take all such other commercially reasonable actions in connection therewith in order to expedite or facilitate the disposition of the Transfer
Restricted Securities pursuant to any applicable Registration Statement contemplated by this Agreement as may be reasonably requested by any Holder in connection with any sale or resale pursuant to any applicable Registration Statement. In such
connection, the Company shall: 
 (A) upon request of any Holder, furnish (or in the case of paragraphs (2) and
(3), use its commercially reasonable efforts to cause to be furnished) to each such Holder upon the effectiveness of the Shelf Registration Statement: 

(1) a certificate, dated such date, signed on behalf of the Company by (x) an executive officer of the Company and
(y) a principal financial or accounting officer of the Company, confirming, as of the date thereof, the matters set forth in Section 6(g) of the Purchase Agreement and such other similar matters as such Holders may reasonably request; 

(2) an opinion, dated the date of effectiveness of the Shelf Registration Statement, of counsel for the Company covering
matters as are customarily covered in opinions requested in connection with underwritten offerings and such other matters as such Holder may reasonably request; 

(3) a customary comfort letter, dated the date of effectiveness of the Shelf Registration Statement, from the
Company’s independent accountants, in the customary form and covering matters of the type customarily covered in comfort letters to underwriters in connection with underwritten offerings; and 

(B) deliver such other documents and certificates as may be reasonably requested by the selling Holders to evidence
compliance with the matters covered in clause (A) above and with any customary conditions contained in the any agreement entered into by the Company pursuant to this clause (ix); 

(x) prior to any public offering of Transfer Restricted Securities, cooperate with the selling Holders and their counsel
in connection with the registration and qualification of the Transfer Restricted Securities under the securities or Blue Sky laws of such jurisdictions as the selling Holders may request and do any and all other acts or things necessary or advisable
to enable the disposition in such jurisdictions of the Transfer Restricted Securities covered by the applicable Registration Statement, but in no event for longer than 365 days from the effective date of the Registration Statement; provided,
however, that the Company shall not be required to register or qualify as a foreign corporation where it is not now so qualified or to take any action that would subject it to the service of process in suits or to taxation, other than as to
matters and transactions relating to the Registration Statement, in any jurisdiction where it is not now so subject; 

(xi) in connection with any sale of Transfer Restricted Securities that will result in such securities no longer being
Transfer Restricted Securities, cooperate with the Holders to facilitate the timely preparation and delivery of certificates representing Transfer Restricted Securities to be sold and not bearing any restrictive legends; and to register such
Transfer Restricted Securities in such denominations and such names as the selling Holders may request at least two Business Days prior to such sale of Transfer Restricted Securities; 

(xii) use its commercially reasonable efforts to cause the disposition of the Transfer Restricted Securities covered by
the Registration Statement to be registered with or approved by such other governmental agencies or authorities as may be 

  
 12 

 
necessary to enable the seller or sellers thereof to consummate the disposition of such Transfer Restricted Securities, but in no event for longer than 365 days from the effective date of the
Registration Statement, subject to the proviso contained in clause (x) above; 
 (xiii) provide a CUSIP number for
all Transfer Restricted Securities not later than the effective date of a Registration Statement covering such Transfer Restricted Securities and provide the Trustee under the Indenture with typed certificates for the Transfer Restricted Securities
which are in a form eligible for deposit with a custodian for the Depository Trust Company; 
 (xiv) otherwise use its
commercially reasonable efforts to comply with all applicable rules and regulations of the Commission, and make generally available to its security holders with regard to any applicable Registration Statement, as soon as practicable, a consolidated
earnings statement meeting the requirements of Rule 158 (which need not be audited) covering a twelve-month period beginning after the effective date of the Registration Statement (as such term is defined in paragraph (c) of Rule 158
under the Securities Act); and 
 (xv) cause the Indenture to be qualified under the TIA not later than the effective
date of the first Registration Statement required by this Agreement and, in connection therewith, cooperate with the Trustee and the Holders to effect such changes to the 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 commercially reasonable efforts to cause the Trustee to execute, all documents that may be required to effect such changes and all other forms and documents required to be filed with the
Commission to enable such Indenture to be so qualified in a timely manner. 
 (d) Restrictions on Holders. Each Holder agrees by
acquisition of a Transfer Restricted Security that, upon receipt of the notice referred to in Section 6(c)(iii)(C) or any notice from the Company of the existence of any fact of the kind described in Section 6(c)(iii)(D) hereof (in each
case, a “Suspension Notice”), such Holder will forthwith discontinue disposition of Transfer Restricted Securities pursuant to the applicable Registration Statement until (i) such Holder has received copies of the
supplemented or amended Prospectus contemplated by Section 6(c)(iv) hereof, or (ii) such Holder is advised in writing by the Company that the use of the Prospectus may be resumed, and has received copies of any additional or
supplemental filings that are incorporated by reference in the Prospectus (in each case, the “Recommencement Date”). Each Holder receiving a Suspension Notice hereby agrees that it will either (i) destroy any
Prospectuses, other than permanent file copies, then in such Holder’s possession which have been replaced by the Company with more recently dated Prospectuses or (ii) deliver to the Company (at the Company’s expense) all copies, other
than permanent file copies, then in such Holder’s possession of the Prospectus covering such Transfer Restricted Securities that was current at the time of receipt of the Suspension Notice. The time period regarding the effectiveness of such
Registration Statement set forth in Section 3 or 4 hereof, as applicable, shall be extended by a number of days equal to the number of days in the period from and including the date of delivery of the Suspension Notice to the Recommencement
Date. 

  
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 SECTION 7. REGISTRATION EXPENSES 

(a) All expenses incident to the Company’s performance of or compliance with this Agreement will be borne by the Company, regardless
of whether a Registration Statement becomes effective, including without limitation: (i) all registration and filing fees and expenses; (ii) all fees and expenses of compliance with federal securities and state Blue Sky or securities laws;
(iii) all expenses of printing (including printing certificates for the Exchange Notes to be issued in the Exchange Offer and printing of Prospectuses), messenger and delivery services and telephone; (iv) all reasonable fees and
disbursements of counsel for the Company; and (v) all fees and disbursements of independent certified public accountants of the Company (including the expenses of any special audit and comfort letters required by or incident to such
performance). 
 The Company will, in any event, bear its internal expenses (including, without limitation, all salaries and expenses of its
officers and employees performing legal or accounting duties), the expenses of any annual audit and the fees and expenses of any Person, including special experts, retained by the Company. 

(b) In connection with any Shelf Registration Statement required by this Agreement, the Company will reimburse the Holders of Transfer
Restricted Securities who are selling or reselling Initial Notes or Exchange Notes pursuant to the “Plan of Distribution” contained in the Shelf Registration Statement for the reasonable fees and disbursements of not more than one counsel,
who shall be selected by the Holders of a majority in principal amount of the Transfer Restricted Securities for whose benefit such Shelf Registration Statement is being prepared. 

SECTION 8. INDEMNIFICATION 

(a) Indemnification of the Holders. The Company agrees to indemnify and hold harmless each Holder, its directors, officers, and
each person, if any, who controls such Holder within the meaning of the Securities Act and the Exchange Act against any loss, claim, damage, liability or expense, as incurred, to which such Holder, director, officer or controlling person may become
subject, under the Securities Act, the Exchange Act or other federal or state statutory law or regulation, or at common law or otherwise (including in settlement of any litigation, if such settlement is effected with the written consent of the
Company), insofar as such loss, claim, damage, liability or expense (or actions in respect thereof as contemplated below) arises out of or is based upon any untrue statement or alleged untrue statement of a material fact contained in any
Registration Statement, preliminary prospectus or Prospectus (or any amendment or supplement thereto) provided by the Company to any Holder or any prospective purchaser of Exchange Notes or registered Initial Notes, or the omission or alleged
omission therefrom of a material fact required to be stated therein or necessary in order to make the statements therein, in light of the circumstances under which they were made, not misleading; and to reimburse each such Holder and each such
director, officer or controlling person for any and all expenses (including the fees and disbursements of counsel chosen pursuant to Section 8(c)) as such expenses are reasonably incurred by such Holder or such director, officer or controlling
person in connection with investigating, defending, settling, compromising or paying any such loss, claim, damage, liability, expense or action; provided, however, that the indemnity in this Section 8(a) shall not apply to any
loss, claim, damage, liability or expense to the extent, but only to the extent, arising out of or based upon any untrue statement or alleged untrue statement or omission or alleged omission made in reliance upon and in conformity with written
information relating to any of the Holders furnished in writing to the Company by any of the Holders. 

  
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 (b) Indemnification of the Company. Each Holder agrees, severally and not jointly, to
indemnify and hold harmless the Company, its directors, officers and each person, if any, who controls the Company within the meaning of the Securities Act or the Exchange Act, against any loss, claim, damage, liability or expense, as incurred, to
which the Company or any such director, officer or controlling person may become subject, under the Securities Act, the Exchange Act, or other federal or state statutory law or regulation, or at common law or otherwise (including in settlement of
any litigation, if such settlement is effected with the written consent of such Holder), insofar as such loss, claim, damage, liability or expense (or actions in respect thereof as contemplated below) arises out of or is based upon any untrue
statement or alleged untrue statement of a material fact contained in any Registration Statement, preliminary prospectus or Prospectus (or any amendment or supplement thereto) or the omission or alleged omission therefrom of a material fact
necessary in order to make the statements therein, in the light of the circumstances under which they were made, 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 such Registration Statement, preliminary prospectus or Prospectus (or any amendment or supplement thereto), in reliance upon and in conformity with written information furnished to the Company by such Holder expressly
for use therein; and to reimburse the Company and each such director, officer or controlling person for any and all expenses (including the fees and disbursements of counsel chosen pursuant to Section 8(c)) as such expenses are reasonably
incurred by the Company or such director, officer or controlling person in connection with investigating, defending, settling, compromising or paying any such loss, claim, damage, liability, expense or action. In no event shall any Holder, its
directors, officers or any person who controls such Holder be liable or responsible for any amount in excess of the amount by which the total amount received by such Holder with respect to its sale of Transfer Restricted Securities pursuant to a
Registration Statement exceeds (i) the amount paid by such Holder for such Transfer Restricted Securities and (ii) the amount of any damages that such Holder, its directors, officers or any person who controls such Holder has otherwise
been required to pay by reason of such untrue or alleged untrue statement or omission or alleged omission. 
 (c) In case any action
shall be commenced involving any person in respect of which indemnity may be sought pursuant to Section 8(a) or 8(b) (the “indemnified party”), the indemnified party shall promptly notify the person against whom such
indemnity may be sought (the “indemnifying party”) in writing and the indemnifying party shall assume and control the defense of such action, including the employment of counsel reasonably satisfactory to the indemnified
party and the payment of all fees and expenses of such counsel, as incurred (except that in the case of any action in respect of which indemnity may be sought pursuant to both Sections 8(a) and 8(b), a Holder shall not be required to assume the
defense of such action pursuant to this Section 8(c), but may employ separate counsel and participate in the defense thereof, but the fees and expenses of such counsel, except as provided below, shall be at the expense of the Holder). Any
indemnified party shall have the right to employ separate counsel in any such action and participate in the defense thereof, but the fees and expenses of such counsel shall be at the expense of the indemnified party unless (i) the employment of
such counsel shall have been specifically authorized in writing by the indemnifying party, (ii) the indemnifying 

  
 15 

 
party shall have failed to assume the defense of such action or employ counsel reasonably satisfactory to the indemnified party or (iii) the named parties to any such action (including any
impleaded parties) include both the indemnified party and the indemnifying party, and the indemnified party shall have been advised by such counsel that there may be one or more legal defenses available to it which are different from or additional
to those available to the indemnifying party (in which case the indemnifying party shall not have the right to assume the defense of such action on behalf of the indemnified party). In any such case, the indemnifying party shall not, in connection
with any one action or separate but substantially similar or related actions in the same jurisdiction arising out of the same general allegations or circumstances, be liable for the fees and expenses of more than one separate firm of attorneys (in
addition to any local counsel) for all indemnified parties and all such fees and expenses shall be reimbursed as they are incurred. Such firm shall be designated in writing by a majority of the Holders, in the case of the parties indemnified
pursuant to Section 8(a), and by the Company, in the case of parties indemnified pursuant to Section 8(b). 

(d) Settlements. The indemnifying party under this Section 8 shall not be liable for any settlement of any proceeding
effected without its written consent, but if settled with such consent or if there be a final judgment for the plaintiff, the indemnifying party agrees to indemnify the indemnified party against any loss, claim, damage, liability or expense by
reason of such settlement or judgment. No indemnifying party shall, without the prior written consent of the indemnified party, effect any settlement, compromise or consent to the entry of judgment in any pending or threatened action, suit or
proceeding in respect of which any indemnified party is or could have been a party and indemnity was or could have been sought hereunder by such indemnified party, unless such settlement, compromise or consent (i) includes an unconditional
release of such indemnified party from all liability on claims that are the subject matter of such action, suit or proceeding and (ii) does not include any statements as to or any findings of fault, culpability or failure to act by or on behalf
of any indemnified party. 
 (e) Contribution. If the indemnification provided for in Section 8 hereof is for any reason
held to be unavailable to or otherwise insufficient to hold harmless an indemnified party in respect of any losses, claims, damages, liabilities or expenses referred to therein, then each indemnifying party shall contribute to the aggregate amount
paid or payable by such indemnified party, as incurred, as a result of any losses, claims, damages, liabilities or expenses referred to therein (i) in such proportion as is appropriate to reflect the relative benefits received by the Company,
on the one hand, and the Holders, on the other hand, from their sale of Transfer Restricted Securities or (ii) if the allocation provided by clause (i) above is not permitted by applicable law, in such proportion as is appropriate to
reflect not only the relative benefits referred to in clause (i) above but also the relative fault of the Company, on the one hand, and of the Holder, on the other hand, in connection with the statements or omissions which resulted in such
losses, claims, damages, liabilities or expenses, as well as any other relevant equitable considerations. The relative fault of the Company, on the one hand, and of the Holder, on the other hand, shall be determined by reference to, among other
things, whether any such untrue or alleged untrue statement of a material fact or omission or alleged omission to state a material fact relates to information supplied by the Company, on the one hand, or the Holder, on the other hand, and the
parties’ relative intent, knowledge, access to information and opportunity to correct or prevent such statement or omission. 

  
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 The amount paid or payable by a party as a result of the losses, claims, damages, liabilities and
expenses referred to above shall be deemed to include, subject to the limitations set forth in Section 8 hereof, any legal or other fees or expenses reasonably incurred by such party in connection with investigating or defending any action or
claim. The provisions set forth in Section 8 hereof with respect to notice of commencement of any action shall apply if a claim for contribution is to be made under this Section 8(e); provided, however, that no additional
notice shall be required with respect to any action for which notice has been given under Section 8 hereof for purposes of indemnification. 

The Company and each Holder agree that it would not be just and equitable if contribution pursuant to this Section 8(e) were determined
by pro rata allocation (even if the Holders were treated as one entity for such purpose) or by any other method of allocation which does not take account of the equitable considerations referred to in this Section 8(e). 

Notwithstanding the provisions of this Section 8(e), no Holder, its directors, its officers or any person, if any, who controls such
Holder shall be required to contribute any amount in excess of the amount by which the total received by such Holder with respect to the sale of Transfer Restricted Securities pursuant to a Registration Statement exceeds (i) the amount paid by
such Holder for such Transfer Restricted Securities and (ii) the amount of any damages which such Holder has otherwise been required to pay by reason of such untrue or alleged untrue statement or omission or alleged omission. No person guilty
of fraudulent misrepresentation (within the meaning of Section 11 of the Securities Act) shall be entitled to contribution from any person who was not guilty of such fraudulent misrepresentation. The Holders’ obligations to contribute
pursuant to this Section 8(e) are several, and not joint, in proportion to the respective principal amount of Transfer Restricted Securities held by each Holder hereunder. For purposes of this Section 8(e), each director and officer of a
Holder and each person, if any, who controls a Holder within the meaning of the Securities Act and the Exchange Act shall have the same rights to contribution as such Holder, and each director and officer of the Company, and each person, if any, who
controls the Company within the meaning of the Securities Act and the Exchange Act shall have the same rights to contribution as the Company. 
 SECTION
9. RULE 144A and RULE 144 
 The Company agrees with each Holder, for so long as any Transfer Restricted Securities remain outstanding
and during any period in which the Company (i) is not subject to Section 13 or 15(d) of the Exchange Act, to make available, upon request of any Holder, to such Holder or beneficial owner of Transfer Restricted Securities in connection
with any sale thereof and any prospective purchaser of such Transfer Restricted Securities designated by such Holder or beneficial owner, the information required by Rule 144A(d)(4) under the Securities Act in order to permit resales of such
Transfer Restricted Securities pursuant to Rule 144A, and (ii) is subject to Section 13 or 15(d) of the Exchange Act, to use its commercially reasonable efforts to make all filings required thereby in a timely manner in order to
permit resales of such Transfer Restricted Securities pursuant to Rule 144. 
 SECTION 10. MISCELLANEOUS 

(a) No Inconsistent Agreements. The Company will not, on or after the date of this Agreement, enter into any agreement with respect
to its securities that is inconsistent with the rights granted to the Holders in this Agreement or otherwise conflicts with the provisions hereof. 

  
 17 

 
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 securities under any agreement in
effect on the date hereof. 
 (b) Amendments and Waivers. The provisions of this Agreement may not be amended, modified or
supplemented, and waivers or consents to or departures from the provisions hereof may not be given unless (i) in the case of Section 5 hereof and this Section 10(b)(i), the Company has obtained the written consent of Holders of all
outstanding Transfer Restricted Securities and (ii) in the case of all other provisions hereof, the Company has obtained the written consent of Holders of a majority of the outstanding principal amount of Transfer Restricted Securities
(excluding Transfer Restricted Securities held by the Company or its Affiliates). Notwithstanding the foregoing, a waiver or consent to departure from the provisions hereof that relates exclusively to the rights of Holders whose Transfer Restricted
Securities are being tendered pursuant to the Exchange Offer, and that does not affect directly or indirectly the rights of other Holders whose Transfer Restricted Securities are not being tendered pursuant to such Exchange Offer, may be given by
the Holders of a majority of the outstanding principal amount of Transfer Restricted Securities subject to such Exchange Offer. 

(c) Third Party Beneficiary. The Holders shall be third party beneficiaries to the agreements made hereunder between the Company,
on the one hand, and the Initial Purchasers, on the other hand, and shall have the right to enforce such agreements directly to the extent they may deem such enforcement necessary or advisable to protect its rights or the rights of Holders
hereunder. 
 (d) Notices. All notices and other communications provided for or permitted hereunder shall be made in writing by
hand-delivery, first-class mail (registered or certified, return receipt requested), telex, facsimile, or air courier guaranteeing overnight delivery: 

(i) if to a Holder, at the address set forth on the records of the Registrar under the Indenture, with a copy to the
Registrar under the Indenture; and 
 (ii) if to the Company: 

Tenet Healthcare Corporation 

1445 Ross Avenue, Suite 1400 

Dallas, Texas 75202 

Facsimile No.: (469) 893-3133 

Attention: Tyler C. Murphy 

With a copy to: 

Gibson, Dunn & Crutcher LLP 

200 Park Avenue 

New York, New York 10166 

Facsimile No.: (212) 351-6202 

Attention: Barbara Becker 

All such notices and communications shall be deemed to have been duly given: at the time delivered by hand, if personally delivered; five
Business Days after being deposited in the mail, postage prepaid, if mailed; when receipt acknowledged, if facsimiled; and on the next Business Day, if timely delivered to an air courier guaranteeing overnight delivery. 

  
 18 

 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 specified in the Indenture. 
 (e) Successors and Assigns. This
Agreement shall inure to the benefit of and be binding upon the successors and assigns of each of the parties, including without limitation and without the need for an express assignment, subsequent Holders; provided, that nothing herein
shall be deemed to permit any assignment, transfer or other disposition of Transfer Restricted Securities in violation of the terms hereof or of the Purchase Agreement or the Indenture. If any transferee of any Holder shall acquire Transfer
Restricted Securities in any manner, whether by operation of law or otherwise, such Transfer Restricted Securities shall be held subject to all of the terms of this Agreement, and by taking and holding such Transfer Restricted Securities such Person
shall be conclusively deemed to have agreed to be bound by and to perform all of the terms and provisions of this Agreement, including the restrictions on resale set forth in this Agreement and, if applicable, the Purchase Agreement, and such Person
shall be entitled to receive the benefits hereof. 
 (f) 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. 

(g) Headings. The headings in this Agreement are for convenience of reference only and shall not limit or otherwise affect the
meaning hereof. 
 (h) Governing Law. THIS AGREEMENT SHALL BE GOVERNED BY AND CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE
OF NEW YORK, WITHOUT REGARD TO THE CONFLICT OF LAW RULES THEREOF. 
 (i) Severability. In the event that any one or more of the
provisions contained herein, or the application thereof in any circumstance, is held invalid, illegal or unenforceable, the validity, legality and enforceability of any such provision in every other respect and of the remaining provisions contained
herein shall not be affected or impaired thereby. 
 (j) Entire Agreement. This Agreement is intended by the parties as a final
expression of their agreement and intended to be a complete and exclusive statement of the agreement and understanding of the parties hereto in respect of the subject matter contained herein. There are no restrictions, promises, warranties or
undertakings, other than those set forth or referred to herein with respect to the registration rights granted with respect to the Transfer Restricted Securities. This Agreement supersedes all prior agreements and understandings between the parties
with respect to such subject matter. 
 (Signature Pages Follow) 

  
 19 

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

  

			
	TENET HEALTHCARE CORPORATION
		
	By:		 /s/ Tyler C. Murphy

	Name:		Tyler C. Murphy
	Title:		Vice President and Treasurer

  
 [Signature Page to
Unsecured Notes Exchange and Registration Rights Agreement] 

			
	The foregoing Agreement is hereby confirmed and accepted as of the date first above written.
	
	BARCLAYS CAPITAL INC.
	
	 Acting on behalf of itself

and as Representative of

the several Initial Purchasers

	
	By: BARCLAYS CAPITAL INC.
		
	By:		 /s/ John Skrobe

	Name:		John Skrobe
	Title:		Managing Director

  
 [Signature Page to
Unsecured Notes Exchange and Registration Rights Agreement]

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