Affidavit of Eligibility and Release

State of _______________________________________________________
County of ______________________________________________________

I, ___________________________________, being duly sworn, say I am ________

years of age, my Social Security number is _____________________________, and my
telephone number is (____)__________.

I am submitting this Affidavit with the understanding that it will be relied upon to
determine my eligibility in the Sacramento Dream Wedding (the "Contest") sponsored by
KXTV & “With a Twyst Wedding & Event Design.”

I affirm and represent that I have complied with all the rules and regulations of this
Contest and that I have committed no fraud or deception in entering the Contest or claiming
any prize. I further represent that I am not an employee of KXTV or Gannett Co., Inc.
whose employees are not eligible to enter the Contest or a member of the immediate family of
any such employee.

By my signature below, I (1) grant KXTV the right to use my name, picture and/or
likeness worldwide in connection with this Contest and in the advertising, promotion and
publicizing thereof by any means without compensation to me; (2) waive, discharge and
release KXTV and Gannett Co., Inc. and any of their respective affiliates, subsidiaries,
representatives, assigns, employees, officers, directors and agents from all rights, claims,
causes of action or objections that I may have, or that may subsequently accrue to me, as to
any use of my name, picture and/or likeness in connection with the Contest; and (3) waive,
release and discharge any and all claims that I may have, or that may subsequently accrue to
me, against KXTV, Gannett Co., Inc., and any of their respective affiliates, subsidiaries,
representatives, assigns, employees, officers, directors and agents in connection with the
Contest and any prize won in connection with the Contest, including but not limited to claims
for damages for death, property damage and personal injuries incurred in connection with the
Contest and/or my use of any element of the prize; and (4) assume the risks of personal injury
or damage to property arising from any activity, and any prizes won, in connection with the
Contest. Further, I agree to indemnify and hold KXTV, Gannett Co., Inc., and any of their
respective affiliates, subsidiaries, representatives, assigns, employees, directors, officers and
agents harmless against any loss, damage or expense, including court costs and reasonable
attorneys' fees, that any of them may suffer or incur as a result of any breach of the foregoing
representations.

I further understand and agree that this waiver, release, hold harmless and assumption
of risk is to be binding on my heirs and assigns.

I also acknowledge that neither KXTV nor Gannett Co., Inc. has arranged for or
carries any insurance of any kind for my benefit or that of my heirs, executors and
administrators relative to my use of the prize, and that I am solely responsible for obtaining
and paying for any life, travel, accident, property or other insurance relative to my use of the
prize. I understand that I will be solely responsible for all taxes.
I also agree to use only the vendors that are provided by this prize. I agree to the theme of
the wedding which is “Enchanted Garden”

I further acknowledge and agree to the conditions set forth in Exhibit I attached.

I am employed by:

_______________________________________________________________
(Name)
_______________________________________________________________
(Street Address)

_______________________________________________________________
(City & State, Zip Code)

________________________________________
(Telephone)

I have been employed for ____ years. My position is:

_________________________________________________________________________.

I agree to return, upon demand, to the sponsor any prize that has been or may be
awarded to me if any statement made by me in this affidavit is false. Furthermore, I have
read the foregoing Affidavit of Eligibility and Release before signing it and warrant that I fully
understand its contents.

________________________________
Signature