Receive a FREE Coaxsher T-Shirt...

Simply get out and use any Coaxsher gear, take a picture of yourself wearing our product and mail or e-mail it back to us with this form filled out!

All forms must be signed and dated, see below.

By signing this release, I hereby give Coaxsher, Inc. and Assigns my permission to use the Images depicting the Property in any Media, for any purpose, which may include, among others, advertising, promotion, marketing and packaging for any product or service. I agree that the Images may be combined with other images, text and graphics and cropped, altered or modified. I agree that I have no rights to the Images, and all rights to the Images belong to Coaxsher, Inc. and/or Assigns.

Image Owner’s signature .........................................................................................

Image Owner’s printed name .............................................................................................

Date ...........................................................................................

Circle T-Shirt Size:   Mens:  M   L   XL   XXL           Womens:  S   M   L   XL

Ship to address: .............................................................................................

Ship to city. State, zip code: .............................................................................................

Mail to address:   PO Box 2131 Wenatchee, Wa 98807-2131

Email to: info@coaxsher.com