<%@LANGUAGE="VBSCRIPT" CODEPAGE="1252"%> Win $500 in Cash by participating in the KBZE 105.9Fm Weight Loss Challenge!
 
 

 

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CONTEST WAIVE AND RELEASE FORM:


MY SIGNATURE BELOW INDICATES THAT I REALIZE AND UNDERSTAND THE RULES AND ALL THE INFORMATION ABOUT THE KBZE WEIGHT LOSS CHALLENGE.

I KNOW THAT I SHOULD SEE A PHYSICIAN BEFORE STARTING ANY DIET OR EXERCISE PROGRAM.

I ASSUME ALL RISKS KNOWN AND UNKNOWN ASSOCIATED WITH MY LOSING WEIGHT AND THE PURSUIT OF THE PRIZE ASSOCIATED WITH THIS PROMOTION.

HAVING READ THIS WAIVER AND KNOWING THESE FACTS, I , FOR MYSELF AND ANYONE ENTITLED TO ACT ON MY BEHALF, WAIVE AND RELEASE KBZE 105.9FM, HUBCAST BROADCASTING, INC., THEIR SUCCESSORS AND/OR ASSIGNS AND THE PROMOTION SPONSORS FROM CLAIMS OR LIABILITIES OF ANY KIND ARISING OUT OF MY PARTICIPATION IN THIS PROMOTION.

I GRANT PERMISSION TO ALL OF THE FORGOING TO USE ANY PHOTOGRAPHS, MOTION PICTURES, RECORDINGS OR ANY OTHER RECORD OF THIS PROMOTION FOR ANY LEGITIMATE PURPOSE.



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SIGNATURE OF PARTICIPANT


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DATE


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WITNESS



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