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Eligibility Requirement, Consents and Releases:
1. If selected as a participant you must execute all waivers and release agreements required by the
Charles Dental Group.
2. You will need to be available for all appointments as scheduled.
3. Applications will only be considered if they are complete. Complete applications consist of the
following:
-Completed application with signatures
-Photos of applicant
-Above the age of 18
All materials you send (including photos) will be retained by and become the property of the
Charles Dental Group and will not be returned to you whether or not you are selected as a contestant.
Any expenses you incur during the application process including postage, shipping, materials preparation
( photos, etc.) are your sole responsibility. The Charles Dental Group will not reimburse you for these
expenses. Only one entry per person is allowed. All decisions of the Charles Dental Group are final and
absolute and not subject to inquiry. The Charles Dental group is not responsible for lost applications.
APPLICATION RELEASE AGREEMENT
I, the applicant listed above, in connection with my application to be
considered to participate in the invisalign sweepstakes program, represent and warrant that the
answers provided by me to the foregoing application questions are true, complete and correct, that I have
completed this application honestly and accurately, and I understand, acknowledge and agree that if any
of the information in this application is found to be false or incomplete, this will be grounds for dismissal
of myself from the participant selection process and/or from the Program. I further authorize the Charles
Dental Group to videotape my visits to the dental office and/or location in the event they elect to do so in
connection with my application and the participant selection process. In addition, each of the undersigned
(including the parent(s) or legal guardian(s) of the applicant) agrees as follows:
I acknowledge that the Charles Dental Group may or may not select me for further consideration to be
part of the Program in their sole and absolute discretion. I acknowledge that if I am selected for further
consideration, I will be required to complete and sign additional application materials, release forms and
other documents. I acknowledge that if I am selected as a potential participant, I may also be required to
submit to medical and other tests and a background check in order for the Charles Dental Group to
consider me as a participant. The Charles Dental Group may use the information in this form for any
purpose in their sole discretion, including making such information public as part of the Program or
otherwise. By signing below, in connection with my application to participate in the Program, I hereby
acknowledge, represent and warrant that:
(i) The Charles Dental Group has no obligation to interview me, and/or select me as a participant, and
may choose participants in its sole and absolute discretion;
(ii) I am not an employee, employees direct family, or an owner of the Charles Dental Group or an owners
direct family;
(iii) I agree to keep strictly confidential all information about the Program that I acquire during the
participant selection process and/or my participation in the Program;
(iv) my name, voice, actions, and likeness will be recorded on audiotape, videotape or otherwise as a part
of this application and participant selection process, and I understand that regardless of whether I am
actually selected to participate in the Program, the Charles Dental Group and their successors, assigns
and licensees may, but are in no way obligated to, actually use such recordings and the contents of this
application within or in connection with the Program, including, without limitation, in advertisements,
promotions, publicity, marketing, merchandising, or in any other manner, in any and all media now known
or hereafter devised, worldwide in perpetuity, and I hereby authorize them to do so even if I am selected
as a participant;
(v) all decisions by The Charles Dental Group concerning selection of participants and all other matters
relating to the Program are final and not subject to challenge or appeal; and
(vi) The Charles Dental Group has no obligation to return any materials submitted by me (including
without limitation this application, any documents, photographs and videotapes submitted by me) as part
of the participant selection process whether or not I am selected as a participant, and the Charles Dental
Group may, but are in no way obligated to, use any such materials in and in connection with the Program,
including, without limitation, in advertisements, promotions, publicity, marketing, merchandising, or in any
other manner.
By submitting this application, I hereby consent to the recording, use and reuse by the Charles Dental
Group and any of their respective licensees, assignees, parents, subsidiaries, or affiliated
entities and each of their respective employees, contractors, agents, officers and directors (collectively
"Releasees") of my voice, actions, likeness, name, appearance, biographical material, and any
information contained in or derived from my application(s) to be a participant in the Program, including,
without limitation, any photos or videotapes submitted by me, editorial comments made by me or about
me, and any audio, video or other recordings or still pictures of me taken during the participant selection
process or contained in any materials or documents submitted by me in connection with my application
(collectively "Likeness") as such may be edited, altered, or modified by the Charles Dental Group or any
of the Releasees in their sole discretion, in any and all media now known or hereafter devised, worldwide
in perpetuity, in or in connection with the Program, including, without limitation, in advertisements,
promotions, publicity, marketing, merchandising, or in any other manner. I agree that the Releasees may
use all or any part of my Likeness, and may alter or modify it regardless of whether or not I am
recognizable. I further agree that Releases exclusively own all right, title, and interest (including, without limitation, all copyrights) in and to any recordings made by any of the Releasees as well as any video that
I have provided in connection with my application and any other materials that I have provided or may
provide in connection with the Program (the "Materials") including, without limitation, the right to edit, alter
or modify the Materials and to use all or part of the Materials and my Likeness in any manner and in any
and all media now known or hereafter devised worldwide, in perpetuity. I grant the rights hereunder
whether or not I am selected to participate in the Program in any manner whatsoever. I release, hold
harmless, and indemnify Releasees from any and all liability arising out of their recording or use of my
Likeness and/or the Materials. I agree not to make any claim against Releasees as a result of the
recording or use of my Likeness and/or the Materials (including, without limitation, any claim that such
use defames me or invades any right of privacy and/or publicity).
By signing this application, to the maximum extent permitted by law, I hereby release, hold harmless and
indemnify the Charles Dental Group and all other Releasees, and any other participants in the
Program, the advertisers connected with the Program, each of their respective parent, subsidiary and
affiliated companies, all other persons and entities connected with or engaged in connection with the
Program, and each of their respective officers, directors, agents, representatives, employees, contractors,
successors, assignees, and licensees (herein the "Released Parties") from any and all claims, actions,
damages, liabilities, losses, costs and expenses of any kind (including, without limitation, attorneys' fees)
arising out of, resulting from, or by reason of, my application for or participation on or in connection with
the Program, including, without limitation, my participation in the participant selection process of the
Program, any exploitation of the Program or my appearance on the Program, the failure of the Charles
Dental Group to select me as a participant, the cancellation of the Program, any use of my Likeness or
the Material in connection with the Program, or the exercise by the Charles Dental Group of any rights
granted by me hereunder, on any legal theory whatsoever (including, but not limited to, personal injury,
property damage, rights of privacy and publicity, false light, or defamation) (collectively the “Released
Claims”). The Released Claims specifically include, without limitation, any and all claims, actions,
damages, liabilities, losses, costs and expenses of any kind resulting from the actions of another
participant or any other third party at any time.
I understand that neither I nor anyone else will be paid for my granting the above rights, or for my signing
this agreement. My participation in the process for the Program, and in the Program itself, do not
constitute a performance and will not entitle me to wages, salary, or other compensation. I agree and
acknowledge that no one (including the Charles Dental Group) has asked me for any money or other
consideration to be considered for participation in the Program.
I have read and fully understand this release form, and I agree to abide by and be bound by them and by
any eligibility requirements determined by the Charles Dental Group in its sole discretion. I acknowledge
that in order to participate in the Program, I will be required to complete and sign such additional
documents as the Charles Dental Group may require, including without limitation an Applicant Agreement
and Release, prior to participating.
BY CLICKING THE 'SUBMIT' BUTTON ABOVE, I HEREBY CERTIFY THAT ALL OF THE INFORMATION PROVIDED ABOVE AND IN THIS APPLICATION IS TRUE AND COMPLETE. I UNDERSTAND THAT ANY FALSE STATEMENT OR MATERIAL OMISSION BY ME MAY LEAD TO MY DISQUALIFICATION FROM PARTICIPATION IN THE PROGRAM AND/OR THE PARTICIPANT SELECTION PROCESS FOR THE PROGRAM.
Consent of Parent(s) or Legal Guardian(s)
[To be signed if any persons signing the above Release Agreement are under the age of 18 (i.e., minor
children)]
I acknowledge that I have read the foregoing Release and am familiar with each and all of the terms,
covenants an conditions contained therein, I am satisfied that said Release is fair and equitable, and I
hereby give my express consent to the execution thereof by my minor child listed above, and will not
revoke my consent thereto at any time hereafter. By clicking the 'SUBMIT' button above I agree that is an act of my signature in a digital form.
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