Release Form for Customer Testimonials

Share your success stories using Fernco products (StormDrain, Wax-Free Toilet Seal, PlumbQwik and QwikSeal).

If your story is selected to be featured on our website we will send you our Limited Edition Fernco Poker Chip set as a token of our appreciation for submitting your story.

Terms

For value received, you represent and warrant that the Testimonial given is original and does not infringe upon the copyright or other proprietary rights of any other person or entity.
You agree that Fernco, Inc. shall own all rights to the Testimonial. You also agree that Fernco, Inc. has the right to use or not to use the Testimonial and to use, reproduce, re-use, alter, modify, edit or change the Testimonial and your name and likeness for any purpose as Fernco, Inc. sees fit.
You agree to indemnify and release Fernco Inc. from any liabilities arising out of or relating to your providing said Testimonial.

Agreement

I agree with the above terms.

Contact Info

First Name

Last Name

Title

Organization

Street Address

City

State/Province

ZIP/Postal Code

Phone Number

E-mail Address

Details

Testimonial / Success Story

Above Ground Connections

Below Ground Connections

Internal Seal Connections

Water Management Solutions

Infrastructure Solutions

Flexible Plumbing Connectors

Release Form for Customer Testimonials

Terms

Contact Info

Details