For all of you who have purchased the Nappylocs Kit and Tool-show your skills!!! It's easy just download this page, sign it and send it along with a clear head shot of your Nappylocs TM. Everyone is eligible!!! Grand prize is a sterling and 18kt gold bead ($75) or a gemstone headband (our choice of gems). All published entries will recieve a free hair care product. Everyone can win!!!! MODEL RELEASE In consideration of compensation as indicated below, receipt of which is hereby acknowledged, I ________________________________ (hereafter "Model"), and ________________________________ (hereafter "Parent" if legally unable to enter contract) as Model's parent or legal guardian, do hereby irrevocably authorize Nappy and Happy permission and authority, to publish, and use in all forms and media and manners for advertising, trade, promotion, exhibition, or Nappylocs Book photographic images or pictures submitted to the Nappylocs contest. Model and Parent do hereby waive any right to inspect or approve the finished product or advertising or other copy that may be used in connection therewith or the use to which they may be applied. Model and Parent hereby release and agree to hold harmless Photographer, his legal representatives, assigns, and all persons acting under his permission or authority, from any liability. Model and/or Parent hereby affirm they (parent or model) posses the legal right to photos entered. If model or parent do not posses the legal right Nappy and Happy shall not be at fault and held blameless if any issues should arise. Parent hereby affirms that he/she is the mother, father, or legal guardian of Model and that Model's date of birth is _____________ and that Parent's date of birth is ______________. Parent hereby affirms that neither Model's nor Parent's execution of this instrument causes a breach of any prior agreement or applicable law, including but not limited to a prior agreement with a modeling agency, talent agency, or photographer. The compensation in connection with this instrument is:sterling and 18 kt gold bead (grand prize) or sterling ponytail holder(grand prize) or hair care products -all published entries. _____________________________________________________________________________________________________________________ ___________ We have read the above authorization and release prior to its execution and are fully familiar with and agree to the contents thereof. Model’s Legal Name:__________________________________Model Name:_____________ Model’s Signature:_________________________________________ Date:_____________ Parent’s Name:______________________________________________________________ Parent’s Signature:______________________________________Date:___________ _____ Address: Street:______________________________________________________________ City:___________________________________State:__________________ Zip:__________ Phone:______________________ Email:__________________________________________ Witness:________________________________ address:___________________________________ date:____________________ Tell us a little about your Nappylocs:________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ How long have you worn Nappylocs?____________ Who did your Nappylocs?______________________________________ Order Number, Date, and, Name used to purchase the kit:_______________________________________________________ Mail form to Nappylocs TM Contest, PO Box 4211, Chesterfield, MO. 63006-4211 (c) 2003 Nappy-N-Happy Site designed and developed by MegWilliams.com