I understand my participation in the Donut Eating Contest, which is part of the Annual

Summer Kick-Off Block Party promoted, sponsored and operated by Cory Business Systems,

LLC d/b/a Tom’s Donuts, and being held at Tom’s Park owned by Cory Investments, LLC,

includes activities which may involve inherent risk and danger that could result in injury to

myself, others, and/or damage to property. acknowledge the inherent risks and hazards

associated with the Donut Eating Contest which include but are not limited to: falls, physical

contact with others and/or objects, and injuries associated with physical activity. I acknowledge

the inherent risks and hazards associated with the Donut Eating Contest which include but are

not limited to: injuries associated with the consumption, digestion of food, choking, and health

issues.

I expressly represent [ am aware of the inherent risks, dangers, and possibility of injuries

and/or damage to property and acknowledge that I am physically and mentally able to participate

in such activity and event and will be participating at my own risk. I agree to follow all

instructions and rules provided by Cory Business Systems, LL.C d/b/a Tom’s Donuts, Cory

Investments, LLC, their respective officers, members, directors, employees, representatives,

agents, and team members of the Donut Eating Contest and/or Annual Summer Kick-Off Block

Party (hereinafter collectively referred to as the “Released Parties”).

I further acknowledge my

participation in the Donut Eating Contest may result in injuries to myself or others, due to my

physical condition, whether those condition(s) are presently known or unknown to me.

( release, indemnify, defend, and hold harmless the Released Parties, as well as all other

organizers, sponsors, partners, volunteers, staff, and agents of the Released Parties, which are

involved or in any way associated with the Donut Eating Contest and/or Annual Summer Kick-

Off Block Party, from any and all, actual or alleged, claims, liabilities, damages, losses, or

expenses (including reasonable attorneys’ fees and expenses) associated, resulting, or in any way

arising out of, or related to the actions, omissions, negligence (actual or alleged) of any of the

Released Parties in the Donut Eating Contest which are part of the Annual Summer Kick-Off

Block Party.

I agree this waiver and release of liability is binding on me, my insurers, representatives,

heirs, assigns, personal representatives, successors, and any other persons or entities asserting

any right, claim, and/or interest through me or on my behalf.

HAVE READ THIS WAIVER AND RELEASE OF LIABILITY, FULLY

UNDERSTAND ITS TERMS AND CONDITIONS, UNDERSTAND THAT I AM GIVING UP

SUBSTANTIAL RIGHTS WHICH I VOLUNTARILY RELEASE AS STATED HEREIN,

AND AGREE TO PARTICIPATE IN THE DONUT EATING CONTEST IN ACCORDANCE

WITH ALL OF THE FOREGOING.