CMT & Banana Boat® Sun Care’s

“Banana Boat® Sunscreen On The Beach” Trip

DECLARATION AND RELEASE FORM (Page 1 of 3)

Performer’s
Name:

Complete
Address:

Phone Number: Day: Evening:

The undersigned acknowledges that he/she will be a member of the production crew for the “Banana
Boat® Suncare’s Sunscreen on the Beach” Contest (the “Contest”) Grand Prize Package by Country
Music Television Ltd. (“CMT”), Banana Boat®, EMI Music Canada and Beaches Resort (collectively the
“Sponsors”) and WestJet, an Alberta Partnership, and WestJet Vacations (“Prize Suppliers”) for in Ocho
Rios, Jamaica. The undersigned will be required to perform in accordance with the Sponsors directions,
at the Beaches resort in Ocho Rios, Jamaica on the dates specified by the Sponsors.

TRIP DETAILS: In consideration for the undersigned’s activities, the undersigned will receive: One (1)
round trip economy airfare from a WestJet Canadian Airport Destination, closest to the undersigned’s
place of residence to a “Beaches” resort in Jamaica, as selected by the Sponsor’s and Prize Suppliers at
their sole discretion; (Flights to Montego Bay, Jamaica depart from the Toronto Pearson International
Airport on, Sunday, December 6, 2009 and return to Toronto, Ontario on Sunday, December 13, 2009)
(the “Trip”). The undersigned will also receive Seven (7) nights standard accommodation at a “Beaches”
resort in Ocho Rios, Jamaica as selected by the Sponsors in their sole discretion (Beaches Boscobel
Resort & Golf Club in Ochos Rios).

The undersigned must provide a valid major credit card for hotel check-in and incidentals.

The undersigned agrees to be bound by the terms and conditions of this Declaration and Release Form.
The undersigned consents to the use of his/her name, city of residence, photograph or other likeness and
voice for any promotion, publicity and/or advertising purposes or for general news and information
purposes by the Sponsors, without additional compensation, in any manner or media without limitation.
The undersigned agrees that there will be no payment to him/her from the Sponsors with respect to the
making of or any use of the photographs or publicity materials described above. The undersigned further
agrees to hold the Sponsors and the other Releasees (as defined below) harmless with respect thereto.

The undersigned hereby releases and forever discharges the Sponsors, Prize Suppliers, their respective
parent, related and affiliated companies, subsidiaries, members, dealers, affiliates, franchisees,
advertising and promotional agencies, suppliers, promoters, owners, their respective management,
principals, shareholders, partners, advisors, officers, directors, agents, representatives, sponsors,
employees, partners, licensees, successors and assigns and anyone who in collaboration with the
Sponsors stages the Contest (collectively, the “Releasees”) from and against any and all manner of
action, causes of actions, suits, debts, covenants, contracts, claims, demands, damages, liability, losses
and expenses including legal fees and expenses, action or causes of action whatsoever, whether known
or unknown, whether at law or in equity, whatsoever, including but not limited to claims based on
negligence or gross negligence on any part of the Releasees, rights of publicity, privacy, defamation or
portrayal in a false light, breach of contract and fundamental breach and liability for physical injury, death,
or property damage which the undersigned or his/her administrators, heirs, successors or assigns might
have or could have, by reason of or rising out of the undersigned’s participation in the Trip supplied
herein.

Without limiting the release outlined above, the Releasees shall in no way be held responsible or liable
for any act or omission performed by me which contravenes any law of Canada or the Jamaica, West
Indies during the Trip.

I hereby declare:
 CMT & Banana Boat® Sun Care’s
“Banana Boat® Sunscreen On The Beach” Trip
DECLARATION AND RELEASE FORM (Page 2 of 3)

1. I shall be solely responsible for all travel and medical insurance, in-flight meals and
entertainment, applicable taxes, incidentals and any and all other expenses not specified in the
Trip Details above.
2. I shall have travel and medical insurance in place for myself prior to, and for the entire duration of,
the abovementioned Trip.
3. I shall be solely responsible for ensuring that all travel papers (passports, etc.) are in good
order and are valid prior to and for the entire duration of the Trip.
4. On behalf of myself, my relatives, heirs, executors and administrators, I hereby permanently,
irrevocably and forever waive any and all claims, now or in the future, of any kind and nature
whatsoever, which I might have against the Releasees with respect to the Trip and I hereby
release any of the aforementioned parties from any and all liability with respect to the Contest and
any and all liability with respect to the acceptance and delivery of the Trip.
5. I hereby release and forever discharge the Releasees from and against any and all manner of
suits, debts, covenants, contracts, claims and demands, damages, liability, losses, expenses
(including legal fees and expenses), actions or causes of action whatsoever, whether known or
unknown, whether at law or in equity including but not limited to claims based on rights of
publicity, privacy, defamation or portrayal in a false light, negligence, alleged negligence or gross
negligence on the part of any of the Releasees, breach of contract and fundamental breach and
liability for physical injury, death, or property damage which I or my administrators, heirs,
successors or assigns might have or could have against any of them, by reason of or arising out
of my participation in the Contest and/or in connection with the acceptance and/or exercise of the
Trip.
6. I hereby grant the Releasees and any and all sponsors and their advertising and promotional
agencies or parties engaged in the development, production and distribution of Contest materials,
the right, irrevocably, to reproduce, copy, publish, broadcast or otherwise use my name, city of
residence, photograph, film rendering, tape recording or videotape or such other likeness of me in
any manner in any promotional activities related to this or future contests and promotions/publicity
and programming purposes, commercial or otherwise. I agree that I shall have no right of
approval, no claim to additional compensation or benefit, and no claim (including, without
limitation, claims based upon invasion of privacy, defamation or right of publicity arising out of any
use or any blurring, distortion, alteration, optical illusion, or use in composite form, whether or no
intentional) in respect of such use.
7. I further agree that I will indemnify the Releasees from and against any and all claims, liabilities,
losses and damages (including court costs and solicitors’ fees) arising out of or connected with or
as a result of my participation in the Contest and/or any element of Trip.
8. This declaration is a true and accurate statement of the facts contained herein and is of the same
effect as if made under oath.
9. Without limiting the foregoing, I agree to forfeit the Trip if any statement made by me herein is
false, or if I have breached any of the terms and conditions or of this waiver/release.

________
 CMT & Banana Boat® Sun Care’s
“Banana Boat® Sunscreen On The Beach” Trip
DECLARATION AND RELEASE FORM (Page 3 of 3)

As a production crew member, I agree to abide by the terms of this Release and the Rules and
Regulations of the Contest.

Witness’
Name (print):
Name:
Witness’
Signature:
Signature:

Date: Date: