Declaration and Release

DECLARATION AND RELEASE

“Ontario Place Oktoberfest 2018” (“Sweepstakes”)

INSTRUCTIONS TO POTENTIAL PRIZE WINNER: Please read this entire Declaration and Release Form (“Declaration and Release”) carefully and complete, legibly, all of the areas below requiring you to submit information. Sign this document where indicated below and mail your completed Declaration and Release to: dvizzari@crystalheadvodka.com no later than five (5) business days after notification.

We suggest you keep a copy of this Declaration and Release for your records.

WINNER'S RELEASE

I do hereby state and declare that I:

[NAME]

[MAILING ADDRESS]

am a selected prize winner (the "Winner") in the Sweepstakes.

I agree to accept the prize consisting of “2”Tickets to Oktoberfest at Ontario Place:

Each prize package is valued at approximately $40.00 (CAD). This prize cannot be substituted for cash value. Entry is only granted to Ontario Place Oktoberfest on the date given on the ticket. Passes are non-transferable. Must be legal drinking age to enter contest.

I understand that before I am entitled to the Prize I must complete and sign this Declaration and Release and correctly answer the following skill-testing question without mechanical or other aid:

Skill-Testing Question:

Multiply 12 x 12

Add 24

Divide by 6

Subtract 20

ANSWER: ______

In consideration for awarding me the Prize, the receipt and sufficiency of which is hereby acknowledged, I hereby:

(a) accept the Prize as awarded and acknowledge that the Prize is as described in the Official Rules of the Sweepstakes;
(b) release Globefill Inc., Owners of Crystal Head Vodka (the “Sponsor”), its parent companies, subsidiaries, affiliates, distributors, prize suppliers, advertising/promotion agencies and the Sweepstakes judges, and each of their respective officers, directors, agents, representatives, employees, successors and assigns from any and all liability in connection with the Sweepstakes, my participation therein and my acceptance, use or misuse of the Prize or any portion thereof; and
(c) consent to the publication, reproduction and/or other use of my name, address, voice, statements about the Sweepstakes and/or photograph or other likeness without further notice or compensation, in any publicity or advertisement carried out by the Sponsor in any manner whatsoever, including print, broadcast or the internet.

I declare that:

(i) I have read and will comply with all Official Rules of the Sweepstakes;
(ii) I am an individual resident of Canada over the age of majority in my province or territory of residence
(iii) neither I nor any person with whom I reside is an employee of the Sponsor, its parent companies, subsidiaries, affiliates, distributors, prize suppliers, advertising/promotion agencies or the Sweepstakes judges; and
(iv) the terms of this Declaration and Release shall apply to and be binding on me and my heirs, executors, administrators, personal representatives, successors and assigns.

If any provision of this Declaration and Release is found to be illegal, invalid or unenforceable, such illegality, invalidity or unenforceability shall not render the balance of this Declaration and Release illegal, invalid or unenforceable.

DATED THIS ______________ DAY OF___________________, 2018.

_____________________________

ADULT WITNESS SIGNATURE

____________________________

NAME

____________________________

WINNER'S SIGNATURE

____________________________

NAME

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