AFFIDAVIT OF ELIGIBILITY AND LIABILITY

I,[name below] represent and warrant that (i) I am a legal  resident  of   one    of   the   fifty   United   States    of   America   or the   District   of   Columbia, (ii) my address is [address below] and  my  home   telephone   number  is [phone number below].


I am submitting this Affidavit of Eligibility and Liability/Publicity Release (this “Affidavit/Release”) to LHO Tom Joad Circle DC Lessee, L.L.C. d/b/a Hotel Zena and Viceroy Hotel Management, LLC ("Sponsor"), with the understanding that it will be relied upon by Sponsor in connection with my having been awarded, subject to eligibility, one of the prizes in the Hotel Zena Mother’s Day Contest (the “Contest”), as such prize is described in the Contest's Official Rules (attached hereto) (the “Official Rules”).

  1. I acknowledge that (i) I have read and  complied with all the rules, regulations, terms and conditions set forth in the Official Rules, (ii) I have not perpetrated and will not  perpetrate  any fraud or deception in connection with the Contest, and (iii) I have not sought to influence the  outcome  of the Contest other than by participating as expressly permitted in the Official Rules.
  2. I represent that I am not an employee, representative, agent, director, officer, supplier, printer, distributor, or advertising and promotional agency of Sponsor and any of its affiliates nor am I an immediate family member (spouse, domestic partner, child, sibling, parent, grandparent, grandchild or step-family member) or a member of the same household (whether related or not) of any such person.
  3. I, ON BEHALF OF MYSELF, MY HEIRS, EXECUTORS, ADMINISTRATORS, AND ASSIGNS, HEREBY RELEASE, FOREVER DISCHARGE AND AGREE TO HOLD HARMLESS THE RELEASED PARTIES (AS DEFINED IN THE OFFICIAL RULES), FROM AND AGAINST ANY LIABILITY FOR ANY AND ALL CLAIMS, DEMANDS, LOSSES AND LIABILITIES OF ANY NATURE WHATSOEVER, AT LAW OR IN EQUITY WHICH I MAY NOW OR HEREAFTER BE ENTITLED TO ASSERT, INCLUDING BUT NOT LIMITED TO ANY DEATH, INJURY, LOSS OF ENJOYMENT, PROPERTY DAMAGE, OR OTHER HARM OR LOSS OF ANY NATURE, ANY CLAIMS BASED ON PUBLICITY RIGHTS, PRIVACY RIGHTS, PERSONALITY RIGHTS, MORAL RIGHTS, OR DEFAMATION, AND ANY AND ALL ANY TAXES LEVIED, ASSESSED OR COLLECTED, WHETHER CAUSED   BY,   CONTRIBUTED   TO,  ARISING  OUT    OF, OR OTHERWISE RELATED TO THE CONTEST, THE PRIZE, OR MY POSSESSION, ACCEPTANCE, USE, OR MISUSE THEREOF, OR MY OTHER ACTS OR OMISSIONS IN CONNECTION THEREWITH.

    I further understand and agree that all rights under  Section  1542 of the Civil Code  of California (“Section 1542”) and any similar law of any state or territory of the United States that I may have with respect to the foregoing release are hereby expressly and forever waived. I understand that Section 1542 provides that:

    A GENERAL RELEASE DOES NOT EXTEND TO CLAIMS THAT THE CREDITOR OR RELEASING PARTY DOES NOT KNOW OR SUSPECT TO EXIST IN HIS OR HER FAVOR AT THE TIME OF EXECUTING THE RELEASE AND THAT, IF KNOWN BY HIM OR HER, WOULD HAVE MATERIALLY AFFECTED HIS OR HER SETTLEMENT WITH THE DEBTOR OR RELEASED PARTY.
  4. I have been given a full opportunity to review and analyze this Affidavit/Release as well as the promotions in the Official Rules for this Contest. I fully and completely understand all of the terms of this Affidavit/Release and sign it voluntarily, freely, and knowingly. I acknowledge and agree that this is a complete release and discharge of all claims and rights of the undersigned against the Released Parties, and that no action will be taken by or on behalf of the undersigned with respect to any such claims or rights, it being understood that this release shall be binding upon my heirs, executors, and administrators, and anyone claiming by or through me.
  5. I hereby irrevocably grant to Sponsor, and those  acting  with  their  authority,  the unrestricted, absolute, perpetual, worldwide right and license to use my name, address, photograph, likeness, voice, biographical and personal background information, statements, and Contest entry, and, without limitation, any photograph, film, or video or audio tape that may be taken of me or of such materials (the foregoing, collectively, the “Content”), without further compensation, consideration, or notice or permission to me or to any third party, and to reproduce, copy,  modify,  create  derivative  works of, display, perform, exhibit, distribute, transmit or broadcast, publicly or otherwise, or otherwise use and permit to be used the Content or any part thereof, whether alone or in combination with other materials (including but not limited to text, data, images, photographs, illustrations, and graphics, video or audio segments of any nature), in any media whatsoever.
  6. I hereby represent and warrant that I have and will continue to have all rights and licenses necessary to grant to Sponsor the full and unrestricted enjoyment of the rights and licenses granted in Section 5 of this Affidavit/Release. I further acknowledge and agree that no Contest Entity or third party shall be obligated to exercise any of the rights or licenses granted under Section 5 of this Affidavit/Release.
  7. I hereby represent and warrant that all  statements  made  by  me  in  this  this Affidavit/Release are  true,  accurate, and complete, and I  hereby  indemnify  the  Released  Parties from  and  against any and  all  losses or damages (including attorneys’ fees)  arising  out  of  or  relating  to  any  statements  or  representations made by me in this Affidavit or otherwise in connection with the  Contest.  I  agree to  return  immediately upon demand to Sponsor the value  of  the  Prize  that  has  been  or  may  be  awarded  to  me  if  any statement or representation made by me in this Affidavit is  discovered  or  believed  to  be  false  or misleading, and I acknowledge and agree that all available legal and equitable remedies may be  pursued against me in connection therewith.
  8. I acknowledge that I am solely responsible for all taxes which may be due on the prize, and that my winning and accepting of the prize will be reported as may be required by law.
  9. I (my parent/legal guardian if I am from a State that deems me to be a minor) have been given a full opportunity to review and analyze this Affidavit/Release as well as the promotions in the   Official Rules for this Contest.  I fully and completely understand all of   the   terms of this Affidavit/Release and sign it voluntarily, freely, and knowingly.

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