INDEMNITY FORM 2018 - Danone

1 INDEMNITY form 2018 Danone SOUTHERN AFRICA (PTY) LTD and ( the participant ) Full Name of Participant 1. Danone is running a football tournament, entitled the Danone Nations Cup sasfa U12 Tournament , commencing in February 2018 . The participant is an U/12 amateur football player and intends to participate in the tournament and agrees to the terms and conditions contained in this agreement. 2. The participant takes part in the tournament entirely at his own risk. Danone , its appointed agency, representatives and sasfa shall not be liable, in any way whatsoever, for any harm, loss or damage which the participant may suffer as a result of his involvement in the tournament, whether this is personal injury or in relation to the property of the participant.

2 3. The participant acknowledges that he is aware that the tournament will be filmed by or on behalf of Danone . The participant hereby agrees that Danone shall be entitled to use and exploit the footage and images obtained by it particularly if required, images of the participant, in relation to the tournament, for all purposes, in all media and throughout the universe. No fee shall be payable for such usage. SIGNED at: on this day of 2018 PARENT / GUARDIAN.