ELIGIBILITY, PUBLICITY AND LIABILITY RELEASE
I, _______________________________ , being duly sworn, say I am at
_________________________________(corporation) and reside at
__________________________________________________________________________________
(Street Address) (City/State) (Zip)
Telephone Number: _________________________ E-Mail Address: ________________________
I am submitting this affidavit and release to CMP Media LLC with the understanding that it will be relied upon to determine my eligibility to participate in the CIO Checklist for Success: An InformationWeek Challenge Sweepstakes which took place from March 12, 2007 to May 15, 2007.
I represent that I have complied with and will comply with all the rules, regulations and limitations of the Promotion and that I have perpetrated no fraud or deception in entering or in claiming any benefits. I further represent that neither I nor members of my immediate household or those with whom I am domiciled are employees of CMP Media LLC, and/or their affiliates or advertising, promotion or production agencies, nor am I or any family member in my immediate household connected with them in any way.
I further agree that by participating in the Promotion, I waive and release any and all rights and claims I may have against CMP Media LLC, and/or their affiliates, agents and assigns, for any matter, cause or thing whatsoever with respect to, or arising as a result of, my participation in the Promotion.
I agree not to participate in any aspect of this Promotion if any statement made by me in this affidavit is false.
I grant permission for the use of my name, city and state for advertising, publicity and promotional purposes in conjunction with the Promotion and similar promotions without additional compensation.
Signed: _________________________
(Signature)
Name: ________________________
Title: _________________________
ATTENTION: To be valid this affidavit MUST BE NOTARIZED
Sworn to before me this _____________ day of ___________, 2005.
___________________________
Notary Public