Celebrating Our Members

First Name

Last Name

Your Passion
(Please keep to approx 35 characters)

Your Story
(Please keep to approx 150 characters)

How Westerra
works for you
(Please keep to approx 75 characters)

Please tell us which gift card you would like

Starbucks Safeway

Please supply your information so we can validate your Westerra Credit Union Membership, and so we know where to send your gift card! ( *Please ensure you are providing the correct address. Your gift card will be sent here.)

Address

City, State, Zip Code

Phone Number

Email Address

Last 4 digits of Westerra Credit Union Account Number

Terms and Conditions (Please read before submission)

For and in consideration of the receipt of a $5 Gift Card, I hereby authorize Westerra Credit Union to use within any and all Westerra Credit Union publications, including website entries, in perpetuity, without notifying me, my name, likeness, photograph, and all or part of the quotation that I have submitted in conjunction with this promotion. I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my name, likeness, photograph or quotation appears.

I hereby hold harmless, release and forever discharge Westerra Credit Union from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other person acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

I am 18 years of age or older and am competent to contract in my own name. I have read this release and fully understand the contents, meaning and impact of this release. I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to signing, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.

*No purchase necessary to enter. The $5 gift card will be mailed to you within two weeks of receipt of your story, photograph and release form. All gift cards will be reported to the IRS as interest as required by law. You may also participate by mailing the above information and a signed statement affirming your acceptance and understanding of the terms herein to Westerra Credit Union, Attn: Marketing Department, 3700 East Alameda Avenue, Denver, CO 80209.

 By submitting this form, I declare that all the information I have supplied is truthful and accurate to the best of my knowledge and I have read and agree to the terms and conditions for this promotion.

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