Leachco Stars Album Info

WANT TO SHOW US YOUR LEACHCO STARS?

It's as easy as 1...2...3!

1) Take pictures of your child (or yourself) using Leachco products.

2) Print and complete this form.

3) Mail your pictures and the following form to:

    Lil' Leachco Stars
    Leachco, Inc.
    P.O. Box 717
    Ada, OK 74821

NOTE: We're sorry, but we will not be able to send the pictures back to you.

Your name:

NOTE: You must be a parent or legal guardian of the child.

Address:

Child's name:

Child's age at time of picture:

Product being used in picture:

AUTHORIZATION TO USE PHOTOGRAPH

I hereby authorize C.J. Leachco, Inc. to reproduce and use the enclosed photographs of:

Child's Name:

Solely for the purpose of displaying on an online photo album at http://www.leachco.com.

I understand that any or all of my pictures may not be displayed depending on various circumstances.
All images I send will not be returned to me, and I will not be compensated.

I further understand this is copyrighted material owned by C.J. Leachco, Inc. alone.

Signed:

(parent or legal guardian)

Dated: