Propel Grocery Sweepstakes

AFFIDAVIT OF ELIGIBILITY AND LIABILITY/PUBLICITY RELEASE

I hereby state:

1. I am submitting this Affidavit/Release to Propel Inc. (“SPONSOR”) and understand that it will be relied upon to determine whether I am entitled to receive the prizes for which my entry is being considered as a winner of the Propel Grocery Sweepstakes (“CONTEST”).

2. I have complied fully with the Official Rules of the CONTEST.

3. As of the date of this Affidavit/Release, I am 18 years of age or older, am resident of Alabama, Arkansas, Arizona, California, Colorado, Connecticut, Delaware, Florida, Georgia, Iowa, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, New Jersey, New York, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Utah or Virginia and am competent and have the right to enter into this Affidavit/Release.

4. I am not an employee or an immediate family member of an employee of SPONSOR, The Kroger Co., Amazon.com, Inc or their respective parents, affiliates, partners, or advertising and promotion agencies.

5. I hereby agree to be responsible for all federal, state and local taxes, and any other costs or expenses incurred in accepting or using any prize(s) I receive.

6. As a potential winner in the CONTEST, I understand that there will be no substitutions of any prize(s) I receive. Prizes are non-transferable.

7. I hereby grant to SPONSOR the right to use, in any medium, for advertising, publicity or trade purposes, my name, picture, portrait, likeness and voice as part of any current or future sweepstakes, contest or advertising promotion conducted by or on behalf of SPONSOR or its designated agencies. I hereby waive any right I may otherwise have to inspect or approve such use, and I release SPONSOR from any claim or liability arising out of any distortion of my name, picture, portrait, likeness or voice, which may arise in the reproduction of my name, picture, portrait, likeness or voice. I also understand and agree that SPONSOR will not return any materials submitted by me on my behalf in connection with the CONTEST

8. I hereby release and hold harmless SPONSOR for any injuries, loss or damages I sustain arising out of my participation in the CONTEST or the acceptance and use of any prize or any travel from or thereto, including any injuries, loss or damages arising out of acts or omissions of all third parties providing goods or services in connection with this CONTEST. This release shall be binding upon me, any family members, heirs, executors, administrators or other assigns. I further understand that neither SPONSOR nor any third party acting at SPONSOR’s direction has arranged or provided for insurance of any kind for my benefit or that of my family members, heirs, executors, administrators or other assigns relating to the use of any prize awarded to me, and that any such insurance is solely my responsibility.

9. I understand that if any statement made by me in this Affidavit/Release is false, then, in addition to any other remedies that may be taken against me, I agree to return to the SPONSOR any prize awarded to me.

I hereby consent to the execution of this Affidavit/Release, agree that the information provided herein is accurate, and, for good and valuable consideration, the receipt of which is hereby acknowledged, agree to be legally bound by the provisions of this Affidavit and Release.