| Contest Release Form |
| |
| First Name:________________________________________________________ |
| (Required) |
| Last Name:________________________________________________________ |
| (Required) |
| Mailing Address:____________________________________________________ |
| (Required) |
| City, State Zip______________________________________________________ |
| (Required) |
| Phone Number:_____________________________________________________ |
| (Required if no E-mail Address) |
| E-Mail Address:____________________________________________________ |
| (Required if no Phone Number) |
| |
| |
| I, ___________________________________________________________ |
| (Please Print) |
| give Stamping Jazzy Style to post the photo of the art piece I'm entering in the contest for marketing purposes. |
| |
| |
| |
| __________________________________ | _____________________ |
| (Signature) | (Date) |