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Name of Owner

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Street Address

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City / State / Zip Code

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Country  / Country Code

Home   _______________________________________________    

Cell      _______________________________________________

Work    _______________________________________________      

Email   _______________________________________________________________

AUTHORIZATION SIGNATURE BLOCK

As a chosen grooming client and pet, I authorize the use of the image in the photo taken at Magic Touch Dog & Cat Grooming of the following named dog or cat (only one is required, both will be used if provided)

Registered name:   _______________________________________________________________

Pet name:  _________________________    and the historical or news information I provide to be used  www.MagicTouchCatandDogGrooming.com for the purpose of being chosen for the

“Featured Groom of the Week Section” on the Front page of the site and a linked

inner page with provided information and additional photos of your pet  that you would like to share.

If you wish to be holding your pet in the photo, please give your permission as well for your image being used for this purpose only.

Client name (please print):____________________________________________________________

Client signature:   _______________________________________________________________________________

You will be notified by email or phone if no email when your pet will be featured. Though named “Featured Pet of the Week” your pet may be on the site longer than one week! Until the next pet is chosen that is.

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Owner’

Witnessed by:

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Carrie Parma-Collier, Magic Touch Cat & Dog Grooming

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Authorized Employee of Carrie Parma-Collier, Magic Touch Cat & Dog Grooming