AFFIDAVIT OF ELIGIBILITY
WAIVER OF LIABILITY
PUBLICITY RELEASE
Name: ______________________________________
Address: ______________________________________
______________________________________
Home Telephone Number: ______________________________________
Business Telephone Number: ______________________________________
Social Security Number: ______________________________________
I am submitting this Affidavit with the understanding that it will be relied upon to determine my eligibility for the opportunity to be married in the TODAY THROWS A DESTINATION WEDDING Special Event. I agree to compensate NBC for any goods or services which may be provided to me if any statement made by me in this Affidavit is false.
I hereby represent that I am a legal U.S. resident 21 years of age or older. I have read and agree to be bound by, and I have complied with and will continue to comply with, all of the rules and regulations of TODAY THROWS A DESTINATION WEDDING, which are published online on the Web site of the TODAY show (www.today.msnbc.com). I represent that I have perpetrated no fraud or deception in applying to be considered for the opportunity to be married on the TODAY show as part of the TODAY THROWS A DESTINATION WEDDING Special Event, or in claiming any service or merchandise that may be provided to me. I have completed the TODAY THROWS A DESTINATION WEDDING application form and I have answered all questions about myself honestly and accurately. I agree that if any of this information is found to be false or incomplete, I may be disqualified from further participation in the TODAY THROWS A DESTINATION WEDDING Special Event. I understand that “Today” may conduct a background investigation on me, and I fully authorize “Today” to do so.
I represent that neither I nor any member of my immediate family nor anyone living in my household is an employee of NBC Universal, Inc. ("NBC"), MSNBC Cable LLC ("MSNBC"), MSNBC.com, NBC's affiliated TV stations or Web site, TARGET, General Electric and their respective advertising and promotion agencies, their parent, subsidiary and joint venture companies, or any other entity affiliated with this Special Event.
I understand that NBC and the TODAY show expect me and my fiance, if select as the wedding couple, to make ourselves available for multiple appearances on the TODAY show and for related publicity and promotion, to be married during a broadcast of the TODAY SHOW, and to take the honeymoon arranged by TODAY, as described in further detail in the Official Rules.
I understand, acknowledge and agree that I am solely responsible for any costs I may incur (including but not limited to any applicable taxes) in connection with this Special Event, except those specifically furnished to me as specified in the Official Rules.
I hereby grant NBC and its licensees permission for use of my name, voice, actions, likeness, appearance, photograph and biographical information about me in television and all other media, in perpetuity, throughout the world, for any purposes including advertising, marketing, publicity and promotion, without additional compensation. I further agree that NBC exclusively owns the application materials (application form, video, photos, etc.) that I have provided in connection with the TODAY THROWS A DESTINATION WEDDING Special Event, and own all rights therein and thereto including, without limitation, the right to use these materials and my name, voice, actions, likeness, appearance, photograph and biographical information about me in any and all media, in perpetuity, throughout the world.
I understand and acknowledge and hereby, for myself, my heirs, executors and administrators, release, hold harmless and forever discharge NBC Universal, Inc. ("NBC"), MSNBC Cable LLC ("MSNBC"), MSNBC.com, NBC's affiliated TV stations or Web site, TARGET, General Electric and their respective advertising and promotion agencies, their parent, subsidiary and joint venture companies, any other entity affiliated with this Special Event, and their past, present and future officers, directors, agents, representatives and employees (collectively “Sponsors”), from any and all liabilities, claims, demands, actions, losses and damages every kind and nature whatsoever, whether known or unknown (including reasonable attorney fees), which I may have in any way relating to or arising from my participation in the TODAY THROWS A WEDDING Special Event and my acceptance or use of and merchandise or services that may be provided to me, specifically including but not limited to claims relating to the use of my name, voice, actions, likeness, appearance, photograph or biographical information about me.
I also acknowledge that none of the above-named companies has arranged for and do not carry insurance of any kind for my benefit or the benefit of my heirs, executors, and administrators relative to my acceptance of any prize related to TODAY THROWS A DESTINATION WEDDING.
________________________________
Signature
________________________________
Print Name
Sworn to before me this
day of , 2004
___________________________
NOTARY PUBLIC