LAUGH-A-DAY ONLINE ENTRY FORM Name:                                                 Email:  Address:                                                Phone: City:               State:        *Age:        *If you are under the age of 18, then please include your parent's name below. Parent's Name/Permission: Yes, I've read & I agree to the contest rules & conditions. PLEASE CHOOSE BELOW THE CATEGORY(IES) THAT YOU WOULD LIKE TO ENTER INTO: (You can choose one or all five). Hearty Laugh Contagious Laugh Funniest Laugh Craziest Laugh Strangest Laugh ENTRY FEE AMOUNT(S): $30 = 1st entry (selected from above) $10 = each additional entry(selected from above) OR $60 = To enter all (5) categories(from above) Please select your total entry fee amount: $30.00 $40.00 $50.00 $60.00 $70.00 METHOD OF PAYMENT: Please select the method of payment that you choose to pay by: Money order Check PayPal STOP!! BEFORE YOU CLICK SUBMIT, PLEASE MAKE SURE THAT YOU'VE DONE THE FOLLOWING: Step 1: Read the contest rules and agree to its terms & conditions(check the box in section 1, above). Step 2: Fill out completely the entry form, and send it by email or mail. Step 3: Pay & Send the entry fee amount by mail(money order/check) or online through PayPal. Step 4: Send a video of your laugh by mail or email(upload). Step 5: Be sure all of the items above are sent together(by mail or email) with your contact information by            November 30, 2005.