DANCE MASCOT CONTEST ENTRY FORM/RELEASE Name: Age: Address: City: State: Zip Code: Phone: Email: As a condition of entering the ASN Mascot Contest (the “Contest”), presented by Sinclair Networks Group, LLC dba American Sports Network, (the “Company”), I warrant, represent, acknowledge and agree as follows: 1. I hereby represent that the picture and/or drawing submitted by me (the “Material”) is my original work and no other parties have rights in or to such work. I agree that the use of the Material provided by me as an entry for this Contest does not violate the rights of any third parties. 2. I hereby grant Sinclair Networks Group, LLC, Sinclair Television Group, Inc., Sinclair Broadcast Group, Inc., their promotional partners, their respective parent, subsidiary and affiliated companies, and the advertising, fulfillment and promotion agencies, agents and representatives of each, as well as the directors, officers, employees, agents and representatives of each and their designees, assignees and licensees (hereafter, collectively, the “Companies”), the worldwide and perpetual right and authority to use, publish, display and reproduce the Material, my voice, photograph, and other likeness and/or any biographical information I may provide, and any statement I make concerning the Contest in any and all media now known or unknown, in perpetuity, for the purpose of the Contest and/or otherwise, without notification or additional compensation, except where prohibited by law. 3. I understand that by entering the Material will become the property of Sinclair Networks Group, LLC, Sinclair Television Group, Inc., and Sinclair Broadcast Group, Inc. and may air on various television stations across the country. In the event that the Material is used for promotional purposes, the Company reserves the right to reproduce it in full or to crop or otherwise edit or modify it for reproduction at its discretion. 4. On behalf of myself, my relatives, heirs, assignees, executors and administrators, I hereby permanently, irrevocably and forever waive any and all claims, liabilities, losses and damages (including but not limited to court costs and attorney’s fees) now or in the future of any kind and nature whatsoever (collectively “Claims”) against the Companies, and their predecessors and successors in interest, insurers, assignees, licensees and designees (the “Released Parties”) relating in any way to: (i) the Contest, including any promotion therein; (ii) the use of the Material by the Company or Companies, (iii) any personal injury, property damage, use of my name or physical likeness as described herein, or any other injury, damage or loss resulting from the my participation in the Contest, including the creation of the Material. 5. I undertake in connection with the Contest, and forever release and discharge the Released Parties from any and all liability with respect thereto. I further agree that I will indemnify and hold the Released Parties harmless from and against all Claims arising out of, connected with or as a result of my breach of this agreement. 6. I further acknowledge that this document, along with the official contest rules, constitutes the entire agreement and complete understanding of the parties, and that no oral or prior written agreements shall be deemed a part or modification of this agreement. This agreement cannot be modified except by a written instrument signed by an authorized representative of the Companies. I agree that if I win the Contest, that I will sign additional documents as required by the Company I am 18 years of age or older, and I have read and agree to the terms of this Entry Form and Release. Signature: _____________________________ Date: _______________ A COMPLETE ENTRY INCLUDES: 1) THIS ENTRY FORM/RELEASE FILLED OUT COMPLETELY BY ENTRANT 2) ONE PICTURE OR DRAWING OF ASN MASCOT
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