Las Vegas Live 2009 Painting Contest

P.O. Box 36462

Las Vegas, NV  89133

 

Name: _____________________________________________

 

Address:  ___________________________________________

 

Phone:  ____________________________________________

 

Email:  ____________________________________________

 

Mold:  _____________________________________________

 

Color:  _____________________________________________

 

Medium:  ___________________________________________

 

Additional Information:  ________________________________

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I understand that the enclosed model is being surrended and is now the property of Las Vegas Live and Jacquie Fernandez.  The model is my entry fee into the painting contest for cash prizes.  Las Vegas Live may use photos of this model for voting and auction purposes.

 

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