Contest Release Form

You must fill out this form and include it with your submission:


What It Means to be a Washingtonian Essay Contest 2008
Contest Start Date: Oct. 20, 2008

AFFIDAVIT OF ENTRANT ELIGIBILITY AND RELEASE OF LIABILITY

STATE OF __________________)

COUNTY OF ________________)

I, _____________________, (type or print legibly full legal name) hereby swear and affirm that:

My birth date is ____________, and my age is _____. I reside at ___________________________ (street address), in _______________________ (city), _____________ (state), ___________ (zip code).


I am submitting this Affidavit to Washingtonpost.Newsweek Interactive, LLC with the understanding that it will be relied upon in connection with my entry into the What It Means to be a Washingtonian Essay Contest 2008 and selection of my essay submission for posting on the website, www.washingtonpost.com (the "Site") and possible inclusion in The Washington Post.

I represent that I have complied with all of the rules and regulations of this contest, that I am a resident of the United States who, as of the start date of this contest, was eighteen years of age or older, and that I have perpetrated no fraud or deception in connection with my entry. I certify that my entry is my original work and does not infringe on any third party's intellectual property rights.

I understand that WPNI may post and/or discuss my submission on washingtonpost.com, a public website, and in The Washington Post and grant WPNI the unrestricted, royalty free, perpetual right to display, modify, perform, copy and create a derivative work from my entry.

I further represent that neither I, nor any member of my immediate family, is now or was at the time of my entering the contest, an employee of Washingtonpost.Newsweek Interactive Company, or its parents, affiliates, subsidiaries, divisions, advertising and promotion agencies.

In the event I do not sign and return this Affidavit, I understand that my entry may be disqualified.

If selected as the winner of the Essay Contest 2008, I agree to hold Washingtonpost.Newsweek Interactive Company, their employees, affiliates, agents, their advertising and promotion agencies and their respective directors, partners, officers, employees, licensees, and assigns harmless from and against any claim that I may have, including any claim relating to injury or accident, reasonably beyond their control and resulting from winning this contest.

I certify that the statements I have made are true and of my own personal knowledge.

Daytime Phone ( ) _________________

Address _________________________

_________________________

Email address: __________________________________________


Signature of Entrant: ____________________________________

Date: ________________

Signature of Witness: ____________________________________
Date: ________________

PUBLICITY RELEASE REQUIRED FOR RECEIPT OF PRIZE

For good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, I do hereby grant to Washingtonpost.Newsweek Interactive Company, their employees, affiliates and agents, and their respective assigns, full permission and authority to use, reproduce, distribute, perform and display, in any manner without limitation as to manner, duration, frequency or territory, my contest entry, name, photograph and/or likeness for purposes of advertising, trade or promotion, in each case in any medium now existing or hereafter developed. I waive all right of inspection and approval and release Washingtonpost.Newsweek Interactive Company, their employees, agents and affiliates and advertising and promotion agencies and their respective assigns from any and all liability arising out of the exercise of the rights granted in this release.


_________________________________
Signature of Entrant and Date

_________________________________
Signature of Witness and Date


By Washington Post staff  |  October 16, 2008; 2:03 PM ET
Next: Contest Rules

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