Join Benny’s club - tell us your story and what bald is…to you.
Feel free to send us your pic too. Sharing will help and encourage others.

First Name :			Email :
			Address just to verify submission not to be shared or posted
Age :			City :
State :			Country :
Photo:
Bald is...	(put in 1 or 2 words)
Comments :
Consent Form:	Photograph/Writing Release Consent Form I hereby give Bald is Beautiful inc. and www.baldis.com, the right and permission to copyright, use, and/or publish and distribute my photographs, images, and written submissions in educational or promotional materials, which include videos, catalogs, articles, magazines, brochures, and website. I understand Bald is…will not be in a position to, and are not committed to attempt to prevent or control any redistribution of such photographs, images, or written submissions by third parties receiving such items from Bald is Beautiful or any other party. I hereby waive any right to inspect or approve the finished videos, photographs, advertising copy, manuscripts or other printed material that may be used by www.baldis.com in connection with any of the above purposes. I hereby release, discharge, and agree to hold harmless www.baldis.com., including the respective directors and employees, from and against any liability as a result of any distortion, blurring, or alteration that may occur in the taking, processing, reproduction publishing or distribution of the finished product, and from any and all claims, actions, and demands of whatsoever nature, including but not limited to claims of libel, defamation, or invasion of privacy, arising out of or in connection with the use of photographs or reproductions. I hereby warrant that I am competent to contract in my own name insofar as the above is concerned. A parent or guardian must sign the release if the individual photographed is under 18 years of age. I have read the foregoing release, authorization, and agreement before affixing my signature below, and warrant that I fully understand the contents thereof.
	I accept