For the Drawing on ENTER the DATE of the DRAWING , for the Purpose of Jointly Playing The

For the drawing on [ENTER THE DATE OF THE DRAWING], for the purpose of jointly playing the [ENTER THE LOTTERY NAME]:

[ENTER THE NAME OF THE POOL PARTICIPANT] designates [ENTER THE NAME OF THE LOTTERY POOL MANAGER] as the Lottery Pool Manager. Each participant shall be liable to contribute $[ENTER THE AMOUNT PER MEMBER TO BE PLAYED PER GAME] which will result in the purchase of [NUMBER OF TICKETS]tickets per participant. Should any participant choose to contribute additional funds for the purchase of additional tickets, they may do so, fully understanding that by doing so, they are not increasing their proportional share of any winnings. Participants and the Lottery Pool Manager are also not in any way restricted from purchasing additional tickets outside the pool, and any winnings from those tickets are not bound by this agreement. See next section for clarification as to how the Lottery Pool tickets are determined so as to allow for this provision.

Each party to the pool shall turn over all funds for the purchase of tickets by [DATE & TIME], which shall allow sufficient time prior to the closing time for purchase of tickets for the drawing. Players acknowledge that Lottery Pool Manager will choose 'quick-pick' randomly assigned numbers, unless one or more participants choses to pre-fill out a card with the numbers they wish to have for their tickets which are part of the pool and provide such form to the Lottery Pool Manager prior to the deadline in this section. As soon as tickets are purchased, they will be digitally photographed, and that photograph of numbers will be distributed to all players for review and to check for winning tickets.

In the event that a person does not sign this agreement or provide funds by the deadline, tickets will NOT be purchased on their behalf, and they will no longer be considered part of the lottery pool for this drawing, and so will not reap any financial benefits or otherwise from any winnings.

In the event that any prizes are won, the Lottery Pool Manager, who shall serve without compensation, shall evenly divide the prize among the participants, deducting any amount owed for a failure to pay a required share. ANY AND ALL FUNDS WON AS PRIZES SHALL BE CONSIDERED TO BE HELD IN TRUST FOR THE POOL BY THE LOTTERY POOL MANAGER. Distribution of funds will be determined by the total number of participants who have entered the pool, and not by their monetary contributions or number of tickets purchased.

Participant hereby agrees that only combined winning funds of all tickets in excess of [THRESHOLD $] will be distributed back to the group. Any combined funds of less than [THRESHOLD $] which are won will go back to [NAME OR ENTITY] and be ear-marked for [FUND PURPOSES].

This agreement shall not automatically renew and shall expire at the completion of the drawing.

In the event of a prize being won in excess of $ 10,000, and settlement options are provided, the vote of the majority of the pool members shall decide. If there is no majority, the Lottery Pool Manager shall decide.

Any member may withdraw by written notice to the pool manager, and their participation in the pool, subject to their tickets having not yet been purchased, shall thereupon end.

This is the entire agreement of the parties and there are no agreements express or implied not stated herein. This agreement may only be altered in writing signed by all parties.

Authorized by the Lottery Pool Manager: [LOTTERY POOL MANAGER NAME], [LOTTERY POOL MANAGER DATE]

Accepted and agreed by Pool Participant: [PARTICIPANT NAME], [PARTICIPANT DATE]