January Winners

Award Permission Form

Congrats! You won! Let us know how to get in contact with you so that you can receive your prize.
Please submit your information below, and we will reach out to you shortly with confirmation.

Be sure to click SUBMIT at the bottom!

Email (required)

Go to your Settings if you don't know which email you use. We need to verify that you're actually you, so please use the same email address.

Mailing Address

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

We appreciate hearing any feedback regarding your experience with us.

Send us a picture of your favorite dish, your family cooking or enjoying a meal together. We will award you an extra 10 points this month for every picture!

Accepted file types: jpg, jpeg, png.

Photo won't attach? Just send them to info@dinnertime.com

Signature*

First Name

Last Name

Date*

Permission*

By checking the box and signing above, I have read and accept the below terms and conditions.



In consideration for your allowing me to accept the Prize, I represent and warrant to the following: Neither I, nor any member of my immediate family or members of my household are, or were at the time that I entered the Contest, employees, officers or directors of DinnerTime, Inc. or its affiliates, subsidiaries, agents, distributors, Prize providers or advertising and promotion agencies (the “Released Parties”). I may, however, be an employee of a client or partner of DinnerTime, Inc. that provides DinnerTime.com as a voluntary employee or health plan or shopper benefit or I may be a general consumer subscriber to DinnerTime.com. I hereby authorize DinnerTime, Inc. to publish my name, any quotes or other submissions, and any photographs taken of me with the promotion item and /or winner certificate, for use in any DinnerTime.com printed or digital publications and website without any further compensation. I am not, however, under any obligation to provide any such quotes or pictures in order to receive such promotion item and/or winner certificate. My company’s name, if applicable, may only be used with the express written permission of my company. I acknowledge that my participation in any publication and websites produced by DinnerTime.com confers upon me no rights of ownership whatsoever. I release DinnerTime.com, its contractors and employees, and all Released Parties, from liability for any claims by me or any third party in connection with my participation. I agree that any taxes due as a result of any award I receive from DinnerTime, Inc. shall be solely my responsibility.