SOUVENIR PRODUCT ORDER FORM - PRINT AND MAIL THIS ORDER FORM
Complete sign and mail order form with payment. Forms not signed will be discarded.
If field does not apply, leave blank. If you need additional fields, fill out custom field and print legibly…
Please use the fields below to include all information pertaining to your order. Information which is not relevant to your order will automatically be purged when your order is completed. Enclose any further info if needed.

SOUVENIR ADOPTION BIRTH:  NOW ONLY:  AUD $190.00     GBP £80.00     EURO €115.00     US$169.00

FULL NAME OF ADOPTED CHILD ON BIRTH CERTIFICATE:                         FIRST                  MIDDLE                       LAST
 


DATE OF BIRTH:                                                    SEX:                                               PLACE OF BIRTH:                                            HOSPITAL:

MONTH/DAY/ CENTURY AND YEAR                            M/F                                                 CITY/COUNTY/STATE/COUNTRY

 


FULL NAME OF ADOPTING MOTHER:

FIRST                                                         MIDDLE                                                LAST 

 


FULL NAME OF ADOPTING FATHER:

FIRST                                                         MIDDLE                                                LAST  
 


SOUVENIR BAPTISM:  NOW ONLY:  AUD $190.00     GBP £80.00     EURO €115.00     US$169.00

LEGAL NAME OF CHILD:                             FIRST                                                         MIDDLE                                                LAST

 

DATE OF BIRTH:                                           COUNTY/COUNTRY                                                 SEX 

 


DATE OF BAPTISM:                                      RACE:                         NAME OF PARENTS:


 
YOUR SIGNATURE:

 

     Add Shipping & Handling To Total:  AUD $15.00     GBP £6.00     EURO €8.00     US$10.00

RUSH ORDERS (CASH ONLY ) ADD AUD $38.00     GBP £17.00     EURO €25.00     US$30.00 

     Payment accepted in any of above currencies by: Cash ___Or Traveler Checks___FOR FASTEST SERVICE 
or by International Postal Money Orders____

We DO NOT accept personal checks or US post office local money orders.
We do accept US post office  INTERNATIONAL MONEY ORDERS ONLY
                                                    
All checks will be held for 30 days and order shipped after clearance.   

PLEASE SHIP MY SOUVENIR DESIGN SOFTWARE PRODUCTS TO MY ADDRESS BELOW!

Name:
 

Address:

City:

State/Province:

Zip:
 


Country:                         E-mail Address: _________________________________________   Phone Number: _______________________
 

Terms and Conditions:  I state, I am the person whom I represent myself to be herein, and I affirm the information within this product application is complete and accurate. I represent, warrant and covenant that: I am at least eighteen years of age and have the full right and authority to enter into this Agreement. I do not reside in any country to which import of souvenir design products are prohibited or restricted. I will not use any of the souvenir software designs in any manner prohibited by any laws, restrictions or regulations. My use of the souvenir design prints does not violate any applicable law or regulation of the country, state, or other   governmental entity in which I reside and accept full responsibility for the accuracy of the information contained in this application as solely mine.  I without reservation or restriction understand fully that you are not an issuing authority of any governmental entity or agency that is authorized to issue official identification documents, means of official identification, or authentication features. I understand your original designs are sold for novelty, commemorative, celebratory, commemoratory, dedicatory, in memory, in remembrance, memorial, observing as a memento, or for a collection or exhibit, for decorative purposes, for a dramatic presentation, such as a theater, film, or television production or for for any other recreational, souvenir or amusement purpose, and any souvenir design is not an authentication feature issued by or under the authority of any government, state, political subdivision of a state, a foreign government, political subdivision of a foreign government, an international governmental or an international quasi-governmental organization. I expressly acknowledge you reserve the right to change, modify, update or discontinue any design for any reason and elect to replace any design with an alternate design as updates become available, and to suspend, cancel, terminate, grant or deny any product order at any time without notice. I hereby authorize you to submit my application for any product required by me through your affiliates, representatives or third party agencies.  I understand any souvenir product is not to be used for any official purpose, or to use, deal with or act upon it as if they were genuine, or to induce any person by the belief that it is genuine. I understand fees are non-refundable for any product, even if the request is denied by its official representative, and you reserve the absolute right to refuse service to any individual for any reason and does not have to provide reason. I understand any third party agency may require a nominal fee for completion of any custom order, and I agree to pay this fee directly to the agency. I understand that I may not copy, reproduce, republish, upload, post, transmit, distribute, and/or exploit any souvenir software design in any way for any official purpose. I understand the use or mention of any tradename, product name, image or trademark on your web site was selected by design as being representative of original format and is in no way intended to suggest that the trademark owner is at all affiliated with or endorses your site, and your original design may vary and is not representative of any officially issued design as all images are trademarks or registered trademarks of original designers, and are for reference only. I understand you do not provide any warranties of merchantability for a particular purpose, and you shall not be liable under any theory or for any damages suffered by me of any product I order. I understand that you will not be responsible for any orders that are not filled correctly or mailed to any address not in my own name. 

By signing this agreement, I attest, affirm, and my signature below serves as evidence that I, the bearer/purchaser, agree to the aforementioned agreement in its entirety and do hereby certify and accept all the terms and conditions contained herein, and agree to be bound by its terms and conditions.

    
                   _________________________________  X ____________________________________     _____________________    
                    Name                                                    Signature                                           Date

NO FEDEX, UPS OR PRIVATE COURIER ACCEPTED. USE YOUR LOCAL POST OFFICE MAIL OR
Global Priority Mail, Priority Mail or British Royal Express FOR FASTEST SERVICE.                        
      
PLEASE MAKE YOUR PAYMENT OUT TO:  CNB  AND  MAIL YOUR ORDER FORM TO:              
                                                                                                                                           
CNB
GLOBAL MAIL REDIRECTION
34152 STN D
VANCOUVER, BC
CANADA V6J 4N2