Monday Night Football 2014

WINNER’S AFFIDAVIT & RELEASECongratulations.As the winner of TicketCity’s Monday Night Football Live Tweeting contest you are required to complete thisAffidavit of Eligibility, Publicity Release, and Release of Liability in order to receive the $50 gift code.AFFIDAVIT OF ELIGIBILITYPlease enter the information below according to the information provided upon contest entry to confirm youreligibility.Name: _____________________________________________________________ (First) (Last)Address: _____________________________________________________________City: __________________________State: ____________Zip Code:_________Email: _____________________________________________________________Phone: _____________________________________________________________Date of birth is required to confirm contest age eligibility requirement; date of birth will remain confidential. Date of Birth: ________________________________ Month / Date / Year Choose one:  By the laws of _________________, I AM of legal age, and therefore I AM NOT A MINOR. (State of residence)  By the laws of _________________, I AM NOT of legal age, and therefore I AM A MINOR. (State of residence) As a minor, please provide contact information for parent or legal guardian. TicketCity will contact the legal guardian to confirm permission to enter. ____________________________________________________________________ Last Name First Name Phone EmailI, __________________________________, certify that the above information provided is accurate. (print name)______________________________________________ __________________________________Signature Date

PUBLICITY RELEASEAcceptance of a prize constitutes permission for TicketCity use a winner's name, information and likeness forpurposes of advertising and promotion in all media, including online, worldwide, without limitation or furthercompensation.I, ___________________________________, understand and agree to these terms of the PUBLICITY RELEASE. (print name)______________________________________________ __________________________________Signature DateRELEASE OF LIABILITYBy the acceptance of this prize, a TicketCity $50 gift code, I release TicketCity from any and all liability forinjury, damages or expenses sustained in connection with this contest, with the receipt, ownership or use ofthe prize, including the events attended from redemption of this prize.TicketCity’s standard Sales Policies (http://www.ticketcity.com/helpful-links/sales-policies.html) apply to anypurchases made with this gift card.I, _________________________________, understand and agree to these terms of the RELEASE FOF LIABILITY. (print name)______________________________________________ __________________________________Signature DatePLEASE COMPLETE AND SIGN THIS FORM AND EMAIL BOTH PAGES TO [email protected] any questions, please contact:Ryan HobertTicketCitySearch Engine Marketing Manager5912 Balcones, Suite 102Austin, TX [email protected]