THE DAVID HEARN FOUNDATION KIA GRANT 2018 APPLICATION

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1 ABOUT THE GRANT The David Hearn Foundation Kia Grant is a joint initiative between Kia Canada Inc. (KCI) and Canadian PGA TOUR golfer David Hearn to encourage and enable junior golfers to give back to their communities by recognizing their local Alzheimer Society chapter. The David Hearn Foundation Kia Grant will award two junior golfers each with a $4,500 cheque to direct to the local Alzheimer Society chapter of their choice. The two grant recipients will also receive the following: I. Invitation to play in the 2018 David Hearn Foundation Charity Classic at Brantford Golf & Country Club on July 30, 2018 (including transportation and accommodations if needed). The winners will also be formally acknowledged by both Hearn and KCI, and their selected Alzheimer Society chapters will be presented with the cheques. II. $500 Gift Card to Golf Town 2018 IMPORTANT DATES: Tuesday May 22, Applications Open Tuesday, June 19, Application EST Wednesday, July 4, Winners Selected Friday, July 6, Winners Announced Monday, July 30, Winners take part in the 2018 David Hearn Foundation Charity Classic (playing golf, reception attendance, and receiving awards) APPLICATION CRITERIA: I. Applicants must be residents of Canada II. Applicants must be ages 18 and under by the award presentation date of July 30, 2018 and enrolled in a recognized Canadian educational institution (elementary school, secondary school, post-secondary school) III. Only one application per person IV. Only fully completed grant applications will be considered V. Applicants must be a involved in golf in some capacity (junior golf program, member of golf course, taking golf lessons, golf camp, etc. ) GENERAL RULES/REGULATIONS: By submitting a Grant Application, applicants (and/or their parent or legal guardian): (1) agree to be bound by the decisions of Sponsors and judges which are final and binding in all matters; (2) grant Sponsors and their designees the right, unless prohibited by law, to use their names, cities and provinces of residence, voices, pictures and likenesses, without compensation, notification or permission, for the purpose of advertising and publicity in any and all media, now or after known, throughout the world in perpetuity; and 1

2 (3) acknowledge and agree that Sponsors will own and administer 100% of the copyright in all applications submitted and may edit, modify, and distribute the applications in any and all media, now or hereafter known throughout the world in perpetuity without limitation at no additional notification or permission of applicants, their parents or legal guardians or any third party. Sponsors expressly disclaim any responsibility and applicants (or their parents or legal guardians if such applicant is a minor) agree to release, indemnify and hold Sponsors harmless for liability, damages or claims for injury or loss to any person or property (including death) relating to, in whole or in part, directly or indirectly, participation in this Grant Application, the acceptance and/or subsequent use or misuse of any prize awarded. Sponsors are not responsible for any injury or damage to persons or property which may be caused directly or indirectly, in whole or in part. SPONSORS: This Grant is sponsored by The David Hearn Foundation and Kia Canada Inc. GOOD LUCK TO ALL APPLICANTS! Name : (First) (Last) Street Address: City: Province: Postal Code: Telephone: ( ) - Birthdate: / / Country of Citizenship: (Month) (Day) (Year) Current School: / / (Name) (City, Province) (Grade) Local Alzheimer Society Chapter: Golf Course Affiliation (If any. If none, write N/A) : 2

3 (Please provide the name and address of your golf course and the contact information for your Director of Golf. ) What does golf mean to you / How has it impacted your life? (Max 250 words) 3

4 Please complete the following chart: SCHOOL, EXTRACURRICULAR & COMMUNITY INVOLVEMENT Organization Dates Responsibilities & Accomplishments A/ Community & Volunteer Service B/ Extracurricular & School Activities Essay Portion: Please describe why you are applying for The David Hearn Foundation Kia Grant and why you would like your local Alzheimer Society chapter to receive the funds. Your essay should provide insight into who you are as a person and the impact the organization has on you, as well as your commitment to giving back to the community. Your response should be no longer than 500 words. Written works are expected to be original and from the applicant. (Space provided on following page): 4

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7 Please have your parent or guardian print their name and sign the below to recognize and agree to your application submission for The David Hearn Foundation Kia Grant. I,, having read, understood and agreed to the above, hereby give my permission for my child/ward,, to participate in The David Hearn Foundation Kia Grant Application. (Signature) (Date) Please scan and completed applications to McKenzie Clarke at mclarke@wearesbx.com by the deadline. Please feel free to any questions about the application in advance. 7

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