Kingpin College Photo/Description Submission Form
Your name: _________________ Your email: ________________
Your mailing address____________________________________
City, ST, Zip________________________________
Mail this form with actual paper photo(s) or CD with photo file(s) to:
In-Stone, 519 Interstate-30 #228, Rockwall, TX 75087.
By submitting photos you agree to our MODEL RELEASE AND CONSENT AGREEMENT:
I irrevocably consent to the use by Kingpin and its successors of all images submitted for advertising and promoting Kingpin hats. This agreement constitutes the sole, complete and exclusive agreement between the parties.
Kingpin College Degree Questionaire
PhD desired(Check one): Beanie Avionics______ or Beanie Design________
Full name with middle initial on diploma: _____________________________
OPTIONAL: Describe any special details about the picture(s) submitted like "At Disneyworld", "In the Price is Right studio audience" or whatever: