Hollywood Diet Store - Share Your Success Story

Share Your Success Story

Share your weight loss success story with other Hollywood Diet Store dieters. If we use your story on our Website, we'll send you a $20.00 off coupon to use on your next Website order. Be sure to include a before and after photo.

* required field

Full Name:*

E-Mail Address:*

Mailing Address:

Sex:*		Age:*
Male Female

Beginning Weight:*		Ending Weight:*

Phone:

Before Photo:

Witness:*

After Photo:

Please check which products you used:*

Hollywood Cookie Diet®
48 Hour Miracle Diet®
24 Hour Miracle Diet®

Tell Us Your Success Story (20 words or more):*

Please read and agree to the following terms and conditions:

For valuable consideration, the receipt and sufficiency of which is acknowledged, I hereby give Sunset Health Products, Inc., its representatives and assigns, or any person(s) or corporation(s) acting under its permission or authority or for whom it might be acting (collectively the "Companies"), the worldwide right and permission to publish testimonials, letters, e-mails, photographs, or other statements from me (the "Statements") and use such Statements in any media for any purpose including advertising, marketing, and promotion My name and photograph may be used along with my Statements.

I hereby waive any and all rights that I may have over the use, distribution, transfer or display of the Statements, including, without limitation any right to inspect and/or approve such use, distribution, transfer or display. I hereby release and discharge the Companies from any and all claims arising from or related to the use of the Statements.

I further acknowledge and affirm (1) that the Statements are factually accurate and represent my honest opinions, findings, beliefs, or experiences, (2) that I was not compensated in exchange for such Statements, and (3) that there exists no material connection between myself and Sunset Health Products, Inc.

I hereby warrant that I am over eighteen years of age, and competent to contract in my own name. This Release shall be binding upon me, my heirs, legal representatives, and assigns. This Release is being made and entered into under the laws of the State of California and shall be governed and interpreted in accordance with the laws of said state. I have read this Release carefully before affixing my signature below, and warrant that I fully understand the contents thereof.

I agree to the terms and conditions