Las Vegas Dealer Incentive Guest Registration

I am submitting this affidavit to Ignition Collective & Ford Motor Company, with the understanding that it will be relied upon to determine whether I am entitled to receive a Grand Prize in the Ford US Dealer Incentive Program - 2024 Formula One Las Vegas GP.

I, a United States resident 18 years of age or older as of October 2024 with a valid driver's license, certify that I have read the rules of this contest and that I am fully eligible to claim such prize.

I certify that I currently reside in one of the 48 eligible states set forth in the rules.

I understand that all Federal, State and Local taxes, and other charges on the prize I may win will be my responsibility.

I understand that as a winner, I will receive the following and that the primary purpose of the trip is to conduct business with employees of Ford:

One (1) Grand Prize: One (1) Ford Pro US Dealer Incentive Program at 2024 Formula One Las Vegas GP on November 20-24, 2024. The prize includes: One (1) hotel room accommodation on double occupancy for four (4) nights; Two (2) R/T airfare based on an economy plus/premium economy ticket for dealer and their guest, Gift card/cash for incidentals, Two (2) gift packages for dealer and their guest; Welcome dinner; Two (2) tickets to access the Red Bull Energy Station on Thursday, Friday and Saturday of the event for dealer and their guest; One (1) Pirelli Hot Lap as part of Ford’s Hot Lap Program; Two (2) Leisure Activities of either Golf or Spa for dealer and their guest; Casino Allowance and ground transportation to/from airport and any additional program events/activities that may be planned.

Approximate Retail Value: $26,100.

In consideration of the receipt of a Grand Prize in the Ford US Dealer Incentive Program - 2024 Formula One Las Vegas GP, I hereby release and forever discharge Ignition Collective, Ford Motor Company, each of their respective subsidiaries, affiliates, advertising and promotion agencies, dealers, retailers, present and former employees, directors or shareholders and agents, (collectively, "affiliates") from and against any and all claims, demands, losses and liabilities of any nature whatsoever, which the undersigned may now or hereafter be entitled to assert, including, but not limited to any death, injury, loss of enjoyment or other harm or loss of any nature whatsoever caused or contributed to by any of the prizes awarded in this dealer incentive. I agree that such liability, if any, rests solely with the manufacturer of the good or the owner or operator of the vehicle from which the death, injury, harm, loss or other damage arises and that no manufacturer of a good or the owner or operator of vehicle or other facility or conveyance, or their affiliates, shall have liability to me for the acts, omissions or negligence of any other manufacturer, owner or operator participating in the Ford US Dealer Incentive Program - 2024 Las Vegas GP or for any death, injury, loss of enjoyment, or other harm or loss of any nature whatsoever arising as a result of such other manufacturer's, owner's or operator's participation.

I hereby agree that Ignition Collective, Ford Motor Company, each of their respective subsidiaries, affiliates, dealers and retailers shall have without further obligation to me, the right to use my name, photograph, likeness and/or voice for promotional purposes, with any or all media including, but not limited to, Internet and new media, without additional personal compensation if I choose to accept this prize.

I understand that I will automatically be disqualified if I make any false statement herein.

I acknowledge that I will automatically be disqualified if this affidavit is not received by 31st October 2024

It is understood and agreed that this is a complete RELEASE AND DISCHARGE of all claims and rights of the undersigned against the aforementioned parties to be released, and that no action will be taken by or on behalf of the undersigned with respect to any such rights, it being understood that this release shall be binding upon the heirs, executors and administrators of the undersigned.