Cutest Kid Contest

Parent or Guardian's Name*

First NameLast Name

Email Address*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Child's Name*

First NameLast Name

Number of Siblings*

Youngest Child's Birthday*

Date

2nd Youngest Child's Birthday

Date

3rd Youngest Child's Birthday

Date

Favorite TV show*

Favorite Color*

Favorite Book*

Which products have you already purchased for your baby? (check all that apply)*

Where did you learn about us?*

What media did you use while researching nursery furniture? (check all that apply)*

Upload a Photo of Your Child*

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Upload a Photo of Your Child

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Upload a Photo of Your Child

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Please see and sign the Model Consent form below:

Model Consent- USAGE: Unlimited, Unrestricted Worldwide

For valuable consideration received, I hereby grant to Delta Enterprise Corp, (herein after referred to as Delta), its subsidiaries and aliates the irrevocable and unrestricted right to use and publish photographs and/or videos of me and/or my child, or in which I and/or my child may be included, for all the following but not limited to; editorial promotion, advertising, trade and publicity (PR/Press Releases, etc), sales collateral material, and to alter the same without restriction.

Model/Actor warrants that no other binding agreement is in force with any other party which would supercede this agreement.

I hereby release Delta and its subsidiaries from all claims and liabilities relating to said photographs and/or videos.

BY SIGNING BELOW, BOTH PARTIES AGREE TO THE TERMS CONTAINED WITHIN THIS AGREEMENT, AND ACKNOWLEDGE UNDERSTANDING OF THE TERMS CONTAINED HEREIN.

E-signature*

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