---

Registration Form

---

First name:	Last name:
Name of business:
Type of business: (see Web ad form groupings)
Street Address:
City:	State: Zip:
Country:
Phone:	Extension: Fax:
Best time to be reached:
E-mail:
Web Site:
Professional organization(s):
Referred to Surfview Entertainment by:

---

STATEMENT OF UNDERSTANDING & INDEMNIFICATION
I agree to indemnify Surfview Entertainment for any legal damages resulting from my listing and Web ad. Should I find grievance with Surfview Entertainment and it's editor, James E. Tessier, I waive my rights to court litigation and agree to use a mutually acceptable third-party from the American Arbitration Association. Knowing that the Surfview Entertainment site is dependent upon its relationship with its internet service provider, which may change from time to time, I will refrain from making claims for damages for those things that are hardware and computer system dependent, (eg., service outage, changes in the URL address for my ad, and other server setup considerations.) Understanding these things, I agree to participate with Surfview Entertainment, understanding that should the editor find fault with the nature of my business or ad, or the timeliness of payments, that my listing and ad may be cancelled and removed from the site without delay.
Agreed to by, (signature please), Today's date:

---

(Do not write below here.)

Acccepted by:		Date :
Notified by:		Date :

---

Print out this form. Make sure it is complete. Sign it. Date it and mail it in along with your Web ad payment form with payment to:
James E. Tessier
4224 N. 31 Place, Ste. 1
Phoenix, AZ  85016
Surfview Entertainment is a trademark of James E. Tessier. Copyright © 1996-2003. All Rights Reserved.
Send comments to sales@surfview.com.  Questions? Call (623) 298-5034