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Leisure List Prize Fulfillment Release Form

Prize Declaration & Release Form

1. Your Details *This question is required.
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The Leisure List – Places to Eat & Drink (“Promotion”)  

INSTRUCTIONS TO POTENTIAL PRIZE WINNER: Please read this entire Declaration and Release Form (the “Declaration and Release”) carefully and complete, all of the areas below requiring you to submit information. Sign this document where indicated below and submit your completed Declaration and Release no later than November 18, 2020 at 12 p.m. CT. Please keep a copy of this Declaration and Release for your records.

IMPORTANT NOTE: All capitalized terms used herein and not defined herein shall have the respective meanings assigned to them in the Official Rules and Regulations of the Promotion found at

All Potential Winners – In consideration for awarding me the Prize, the receipt and sufficiency of which are hereby acknowledged, I hereby:
  • accept the Prize (as awarded) and acknowledge that the Prize is: (i) as described in the Rules; and (ii) subject to all of the terms, conditions, restrictions, limitations and/or exclusions relating to the Prize as set-forth in the Rules; 
  • release Leisure Travel Vans, a brand of Triple E Canada Ltd. (the “Sponsor”), and its parent companies, affiliates, prize suppliers, advertising/promotion agencies and any other individual(s), entity or entities involved in the development, implementation, administration or fulfillment of the Promotion (collectively, the “PromotionParties”) and each of their respective agents, employees, directors, successors, and assigns (collectively, the “Released Parties”) from any liability in connection with the Promotion, my participation therein and/or my acceptance, use or misuse of the Prize or any portion thereof;
  • accept that notwithstanding any other provision herein, the sole obligation and collective liability of the Released Parties, and my sole remedy for any claim in any way connected with or arising out of this Declaration and Release, the Prize and my acceptance, use or misuse of such Prize or any portion thereof, or the Promotion and my participation therein, shall be for actual and direct damages only, which shall not exceed, in the aggregate, the approximate retail value of the Prize, as set forth above;
  • accept that in no event shall the Released Parties be liable for loss of savings or earnings, mental distress, inconvenience, or indirect, special, consequential, incidental, punitive or exemplary losses, damages or expenses, arising hereunder or in connection with this Declaration and Release, the Prize and my acceptance, use or misuse of such Prize or any portion thereof, or the Promotion and my participation therein, even if the Promotion Sponsor has been advised of or is aware of the possibility of such losses, expenses or damages; 
  • agree that, to the fullest extent permitted by applicable law, I may not seek reimbursement or pursue any legal or equitable remedy from either the Promotion Sponsor or any of the other Released Parties should the Prize fail to be fit for its purpose or is in any way unsatisfactory; 
  • accept that the limitations, exclusions and disclaimers set out herein shall apply irrespective of the nature of the cause of action or claim, including, but not limited to, breach of contract, tort (including negligence) or any other legal theory and shall survive any consummation of the Prize; 
  • understand that the Promotion Sponsor hereby holds in trust for and on behalf of the other Released Parties the benefit of the releases, limitations, exclusions and disclaimers set forth herein and such other Released Parties are third party beneficiaries of such releases, limitations, exclusions and disclaimers; and 
I declare that:
  • I am a natural person who is a legal resident of Canada (excluding Quebec), the 50 United States or Washington D.C.;
  • At the time of entry I had reached the legal age of majority in my jurisdiction of residence; 
  • I am not an employee, representative or agent (or living with any such employee, representative or agent) of any of the Promotion Parties; 
  • I have read and will comply with the Rules; and
  • the terms of this Declaration and Release shall apply to and be binding on me and my heirs, executors, administrators, personal representatives, successors and assigns.
If any provision of this Declaration and Release is found to be illegal, invalid or unenforceable, such illegality, invalidity or unenforceability shall not render the balance of this Declaration and Release illegal, invalid or unenforceable.

I understand that before I am entitled to the Prize, I must complete and sign this Declaration and Release, and return it to the Sponsor as set out above.
3. Prize Winner's Signature *This question is required.
Signature of