Affidavit of Eligibility & Liability / Publicity Release

The Frontline Heroes Challenge

I am submitting this Affidavit of Eligibility & Liability / Publicity Release (“Affidavit”) with the understanding that it will be relied upon to determine me and my family’s eligibility as the Winning Family in The Frontline Heroes Challenge (the “Promotion”), sponsored by America Salutes You, LLC (“Sponsor”).

In order for me and my family’s eligibility to be confirmed, I represent the following, under penalty of perjury:

  1. I was age 18 or older at the time of entry, and I am a legal resident of the United States, including the District of Columbia.
  2. I have read the Official Rules (a copy of which accompanies this Affidavit), and I agree to be bound by them and have complied with all the terms and conditions of the Official Rules. 
  3. I am not an employee, officer, or director of the Sponsor, or of any other entity stated in the Official Rules whose employees are not eligible to enter the Promotion, or a member of the family of any such employee and meet any other eligibility requirements as stated in the Official Rules.

By signing and returning this Affidavit, I agree to accept the Prize consisting of a Frontline Heroes Challenge prize package of a trip for one (1) winning family to Nashville, Tennessee to attend the America Salutes You benefit concert on October 29, 2020. Prize package will include:

  • Round-trip, coach-class airfare for each Family Member participating in the winning entry video to Nashville, Tennessee from a major airport near the Winning Family’s residence. 
  • Two (2) days/One (1) night hotel accommodations. 
  • VIP passes for the Winning Family to the America Salutes You benefit concert at the Grand Ole Opry House in Nashville, Tennessee on October 29, 2020. 

This prize has an approximate retail value of $4,000; actual prize value will depend on the cost of the travel and number of Family Members.  

Please see the attached Official Rules for complete prize details and conditions.

Prize Conditions:  There are certain prize conditions and restrictions stated in the Official Rules, which I must agree to as a condition of accepting a prize in the Promotion.  Some (but not all) of these important conditions are as follows:

  • Prize must be used on dates specified or prize will be forfeited. Dates are subject to change.Travel is subject to availability. 
  • Sponsor will, in its sole discretion, determine which airport is closest to the Winning Family’s home. In the event the Winning Family’s residence is close enough to Nashville, TN such that air transportation is deemed by Sponsor in its sole discretion to be unnecessary, the Sponsor reserves the right to substitute round-trip ground transportation to/from the Winning Family’s home in lieu of air transportation.
  • Winning Family must travel on same itinerary.
  • Winning Family is responsible for obtaining all proper travel documentation (e.g., valid photo ID and/or passport with a minimum validity 6 months after the date of return) prior to travel.

Release of Liability:  On behalf of myself, my heirs, executors, administrators and assigns, I hereby release and forever discharge Sponsor, their respective parents, affiliates, subsidiaries, consultants, contractors, and legal, advertising, public relations, promotional, fulfillment, and marketing agencies, website providers/web masters, and any person, persons, or corporations acting under their permission or authority, from and against any and all liability, claims, or actions of any kind whatsoever for injuries, damages, or losses to persons and property that may be sustained directly or indirectly as a result of my receipt, use, or ownership of any prize awarded to me in connection with the Promotion, or while traveling to, preparing for, and/or participating in any prize-related activity.

I acknowledge that this Release extends and applies to and also covers and includes all unknown, unforeseen, unanticipated, and unsuspected injuries, damages, loss, liability, and the consequences thereof, as well as those now known to exist.  The provisions of any Federal, state, local, or territorial law or statute providing in substance that Releases shall not extend to claims, demands, injuries, death or damages that are unknown or unsuspected to exist at the time, to the person(s) executing such releases, are expressly waived.  

Publicity Release: I grant Sponsor and its agents permission to use my name, prize won, hometown, likeness for purposes of advertising, promotion and publicity (including online posting) in any and all media now or hereafter known throughout the world in perpetuity, without additional compensation, notification or permission.

By accepting this prize, I understand that the IRS mandates that a Form 1099-MISC must be issued to me in January of the year following prize fulfillment for the published ARV of the prize.  Any federal, state and/or local taxes on this prize are my responsibility to pay.  I understand I will receive this Form in January 2021 for the value of this prize.

I understand that this Affidavit must be returned and received by Sponsor no later than five (5) days from the date of the notification, or I will be deemed disqualified and an alternate winner may be notified. 

I agree to return immediately upon demand to the Sponsor any prize, or the value of said prize, which has been or may be awarded to me if any statement made by me in this Affidavit is false.

A copy of each individual’s driver’s license or other government-issued ID accompanies this document.

My Signature Below Represents That I Have Carefully Reviewed And Am In Agreement With All The Information And Statements Above.

  • Each individual must complete and sign this document.
  • Return all required documentation per the instructions as outlined in the original notification you received.
  • All required documentation is due in our office by the due date stated in the notification.
  • Prize will be forfeited if required documentation is not received by the due date.

Should you have questions, [email protected]mail.com.

WINNING FAMILY – INDIVIDUAL #1

I confirm that I am over 18 years of age and that I am fully able to enter into this agreement. 

Signature Date

Print Name                                                           

Address

City State Zip

Date of Birth       Phone

Email                                                            

[Signature blocks for Individuals #2 – #4 on the next pages]

WINNING FAMILY – INDIVIDUAL #2

I confirm that I am over 18 years of age and that I am fully able to enter into this agreement. If I am under 18 years old, my parent or guardian also has signed the Parental/Guardian Consent below, on my behalf.

Signature Date

Print Name                                                           

Address

City State Zip

Date of Birth       Phone

Email                                                            

PARENTAL/GUARDIAN CONSENT:  I am the parent and/or legal guardian of ___________________, the above-identified minor, and have full authority to authorize the above Affidavit, which I have read and approved.

(Signature) (Date)

WINNING FAMILY – INDIVIDUAL #3

I confirm that I am over 18 years of age and that I am fully able to enter into this agreement. If I am under 18 years old, my parent or guardian also has signed the Parental/Guardian Consent below, on my behalf.

Signature Date

Print Name                                                           

Address

City State Zip

Date of Birth       Phone

Email                                                            

PARENTAL/GUARDIAN CONSENT:  I am the parent and/or legal guardian of ___________________, the above-identified minor, and have full authority to authorize the above Affidavit, which I have read and approved.

(Signature) (Date)

WINNING FAMILY – INDIVIDUAL #4

I confirm that I am over 18 years of age and that I am fully able to enter into this agreement. If I am under 18 years old, my parent or guardian also has signed the Parental/Guardian Consent below, on my behalf.

Signature Date

Print Name                                                           

Address

City State Zip

Date of Birth       Phone

Email                                                            

PARENTAL/GUARDIAN CONSENT:  I am the parent and/or legal guardian of ___________________, the above-identified minor, and have full authority to authorize the above Affidavit, which I have read and approved.

(Signature) (Date)