MASON

Criteria: Tampa Lightning colors. Itech Envy mask. Memorial mask for John Walsch (Fireman and Marine). Name on shin with "In Loving Memory". On Side Iwo Jima memorial image. Other to have memorial street sign as provided. Top to have crossed axes on maltese cross with helmet as provided over both.

I hereby authorize the above sketch and written description to be painted on my goalie mask at the quoted price. I will defend & indemnify Don McClelland Designs and any of their agents against any and all liability, loss, expenses, or consequential damages arising from any claims of libel due to infringements of registered logos, characters, trademarks, copyrights and licensing agreements pertaining to this custom paint job. I understand that any payment made by personal check will be held until the payment clears the bank prior to the shipping of the mask. I agree to pay any and all duties or customs charges associated with the shipping of this mask. Any returned check will incur a $25 returned check fee to Don McClelland Designs in addition to any fees your bank may issue. By signing and dating below I acknowledge that I have read, understand and agree to all the above conditions.

Signature:

Date:

Ship To Name:

Address:

City, State, ZIP:

Phone Number:

E-mail: