LABRADOR QUILT RELEASE FORM

Please print this release form and return it with your quilt block to:

Sue Erickson
12230 WCR 66
Greeley, CO  80631

If you wish, please include a story about the special Lab you are honoring. We will post these stories on a special web page for all to read.

**********************************************************


NAME: _______________________________________________________
ADDRESS: ____________________________________________________
CITY: ______________________  STATE: ______  ZIP CODE: __________
E-MAIL: __________________________________________

RELEASE STATEMENT (SIGNATURE REQUIRED)

My signature on this Release Form indicates my acceptance of all the rules. I understand that my submitted block becomes property of LABMED and my be used by LABMED for fund raising purposes. I agree that my block may be photographed and published. I understand that the story I submitted may also be used for publicity purposes.

SIGNATURE____________________________  DATE_________________

Return to Rules Page