The undersigned, in consideration of being permitted to participate in Spend & Earn at Coquitlam Centre and in connection therewith being permitted to enter upon the lands and premises surrounding the Coquitlam Centre, 2929 Barnet Highway, Coquitlam, British Columbia, the undersigned:

A. do hereby unconditionally remise, release and forever discharge Morguard Investments Limited and Pensionfund Realty Limited, (Coquitlam Centre), (collectively the “Entities”) and their directors, officers, employees, affiliates, managers, servants, sponsors, and agents (collectively the “Representatives”) and each of them from and against any and all losses, claims, actions, damages, costs, liabilities, expenses and demands whatsoever (collectively the “Claims”) for death, bodily injury, personal injury, damage or loss to property and any other loss or injury, including without limitation, economic loss or consequential damages (collectively “Damages”), suffered by the undersigned arising howsoever from or out of my participation in this event, entering into the Coquitlam Centre or upon its surrounding lands and premises, whether occasioned, wholly or in part, by any act or omission, whether negligent or otherwise, including, without limitation, gross negligence, on the part of any one or more of the Entities or Representatives; and;

B. shall indemnify and save harmless the Entities and the Representatives and each of them from and against any and all Claims for any and all Damages suffered by the undersigned and/or any other person or persons arising howsoever from or out of my participation in this event, entering into the Coquitlam Centre or upon its surrounding lands and premises, whether occasioned, wholly or in part, by any act or omission whether negligent or otherwise, including, without limitation, gross negligence, on the part of any one or more of the Entities or Representatives.

C. do hereby transfer to Coquitlam Centre all rights whatsoever which I have in the photographs and videos that they have taken of me. I consent to the use of the photograph and videos for both internal (Company Newsletters, Emails) and external usage (Coquitlam Centre website, Coquitlam Centre’s Facebook, Twitter, YouTube, Flickr, Instagram, FourSquare pages, newspaper advertising, mall signage, Media Releases to local and regional newspapers) and agree it may be printed and published in this manner, without incurring debts or liabilities of any kind. It is understood that Coquitlam Centre will not transfer their rights in these photographs and videos to others with this consent.

The undersigned acknowledges and agrees that this Release and indemnity shall be binding on the undersigned and my heirs, executors, administrators, successors and assigns and shall enure to the benefit of the Entities and the Representatives and their respective heirs, executors, administrators, successors and assigns.

It is UNDERSTOOD that the party receiving this Release and Indemnity does so on behalf of each and every person and class of person so released and indemnified and that the said permission is given or shall be deemed to have been given by each person and class of persons as consideration for my release. I warrant that I am of full age of majority and have every right to contract in my own name in regard to the subject matter hereof. I further warrant that I am in good physical condition and health, and have no medical problems which would prevent me from safe participation in the Spend & Earn and I acknowledge being advised to seek medical advice to ensure same.

Participant Information

As agent for the owner of Coquitlam Centre, Morguard Investments Limited (“Morguard”) is committed to maintaining the security and confidentiality of personal information in accordance with applicable privacy legislation and our Privacy Policy. By completing and signing this form, you are consenting to Morguard collecting, using and disclosing your personal information in order to identify and communicate with you, for such other purposes as may be necessary in order to provide you with the products and/or services you have requested, and for any other purposes where you consent or where such collection, use or disclosure is permitted or required by law. You represent that you have all necessary authority and/or have obtained all necessary consents from any other individuals about whom you have disclosed personal information to Morguard in order to enable us to collect, use and disclose such personal information to fulfill the purposes described above. For further information regarding Morguard’s personal information handling practices, please refer to Morguard’s Privacy Policy at www.morguard.com.