1. I, ______________________________________________ from (Company Name) ___________________________________ Mobile No. _________________________ hereby commit to participation in the MAD CHARITY™ USA Golf Classic on Monday, July 28 th, 2014 at Liberty National, Jersey City, New Jersey. INDIVIDUAL AND/OR ORGANIZATION RESPONSIBLE FOR GOLF BOOKING: Name: Company: Mobile: E-Mail Address: Delivery Address: Sponsor / Donor Information to appear on the invoice: SPONSORSHIP DETAILS : (Tick applicable box) **PLEASE VIEW DETAILS OF SPONSORSHIP OPTIONS LISTED ON PAGE 3 Foursome Entry: US$ 6,000 Individual Entry: US$ 1,500 Dinner Only Tickets: US$ 500 Title Sponsorship: US$ 25,000 Presenting Sponsorship: US$ 10,000 Live Auction Item Contribution: Gift Bag Item Contribution: Prize Sponsorship: I would like to make a donation to MAD: YesNumber of Teams: YesNumber of Entrants: Yes Specify: 4 x 1st Prizes @ $350ea4 x 2nd Prizes @ $300ea4 x 3rd Prizes @ $250ea YesValue: YesNumber of Guests:Dietary Requirements: MAD CHARITY™ USA Golf Classic | 7.28.2014 REGISTRATION FORM AND PLAYER INFORMATION

2. PLAYER INFORMATION: Name: Surname: Company: Tel No.: Mobile No.: E-Mail: Dietary Requirements: Handicap:Golf Shirt Size: PLAYER ONE: Name: Surname: Company: Tel No.: Mobile No.: E-Mail: Dietary Requirements: PLAYER TWO: Handicap:Golf Shirt Size: Name: Surname: Company: Tel No.: Mobile No.: E-Mail: Dietary Requirements: Handicap:Golf Shirt Size: PLAYER THREE: Name: Surname: Company: Tel No.: Mobile No.: E-Mail: Dietary Requirements: Handicap:Golf Shirt Size: PLAYER FOUR: BOOKING CONFIRMATION: VERY IMPORTANT: Please return this form to Lauren Krüger at lauren@madcharity.org Proof of payment to be submitted within 48hours of registration. Please note any bookings made telephonically or via e-mail will only be held for 48hours. Your booking will only be confirmed once the booking form along with the proof of payment is received. Bookings are handled on a first come first served basis.lauren@madcharity.org Please note that any cancellations received 45 days prior to the event will be charged at 50%. Should cancellation take place within 30 days of the event, the booking will be charged for in full. CANCELLATION POLICY: MAD CHARITY™ is a registered charity in the USA, UK and South Africa. Donations to a non-profit Sol (C)(3) Corporation are tax deductable for U.S. Federal Income Tax purposes. Please specify your Payment Method: PAYMENTS: Check: EFT: Please make all checks payable to The MAD Bunch USA Inc. Checks can be posted to: C/O Oak Hill Advisors, Attn: Eitan Arbeter (The MAD Bunch USA Inc), 1114 Avenue of the Americas, New York, NY, 10036-7772 Should you wish to make a wire transfer, please call Eitan Arbeter at 212-326-1506 and we will provide you with the relevant banking details. MAD Head Office South Africa: Lauren Krüger or Marita Dewberry Office Number: +27 (0)21 464 8819, Mobile Number: +27 82 303 3377, Email Address: lauren@madcharity.org or marita@madcharity.orglauren@madcharity.orgmarita@madcharity.org ENQUIRIES: MAD CHARITY™ USA Golf Classic | 7.28.2014 REGISTRATION FORM AND PLAYER INFORMATION - continued

3. FOURSOME ENTRY – US$ 6,000: Foursome entry offers one team the opportunity to participate in the MAD Charity Golf Tournament. This rate includes the following per player: Green Fees Golf Carts (as well as one Ball Spotter per Foursome) Registration Packs, including a branded Golf Shirt On-Course Refreshments Prize Giving Dinner INDIVIDUAL PLAYER ENTRY – US$ 1,500: Individual Player Entry offers you one spot in a Foursome in the MAD Charity Golf Tournament. This rate also includes the following: Green Fees Golf Carts (as well as one Ball Spotter per Foursome) Registration Packs, including a branded Golf Shirt On-Course Refreshments Prize Giving Dinner DINNER ONLY TICKETS – US$ 500: Should you be unable to attend the Golf Day, but wish to join us for the Prize Giving Dinner and Fundraising Auction please purchase a Dinner Only Ticket. This per person rate includes a cocktail reception, a three course meal and all beverages. TITLE SPONSORSHIP – US$ 25,000: The Title Sponsorship Package for this event includes the following benefits: Naming rights of the 2014 event Name/logo to appear on all marketing, PR and event collateral materials Prominent signage displayed throughout the golf course on the day Right to create promotional displays, host competitions or present products at two holes on the course during the Golf Day Opportunity to contribute company branded gift-bag item One Foursome entry including access to the Cocktail Reception and Dinner for each golfer Four additional tickets to the Cocktail Reception and Dinner PRESENTING SPONSORSHIP – US$ 10,000: The Presenting Sponsorship Package for this event includes the following benefits: Presenting Sponsor of the 2014 event Name/logo to appear on all marketing, PR and event collateral materials Prominent signage displayed on two holes on the course during the Golf Day Right to create promotional displays, host competitions or present products at one hole on the course during the Golf Day Opportunity to contribute company branded gift-bag item One Foursome entry including access to the Cocktail Reception and Dinner for each golfer LIVE AUCTION ITEM CONTRIBUTION: This event will include a high end, live auction which will be held during the evening’s proceedings. We are looking for unique auction items and exclusive experiences. Benefits for your donation would include: Listing in all pre-event auction promotions Listing in all day-of auction materials Live mention during the auction Items and/or promotional materials included in auction display GIFT BAG CONTRIBUTION OR PRIZE SPONSOR: Sponsors have the opportunity to contribute product and/or a high end branded item for event gift bags and/or golfing prizes. Gift bags will be given to celebrity participants, dignitaries, VIPs and all golfers. Prizes will be given in various categories such as top gross score, top net score, longest drive and closest to the pin. THANK YOU FOR YOUR PARTICIPATION www.madcharity.org MAD CHARITY™ USA Golf Classic | 7.28.2014 SPONSORSHIP DETAILS