* FIRST NAME
   
* LAST NAME
     
* HOME PHONE#
  
  E.g. 093337777 (no spaces please)
* WORK PHONE#
  
  E.g. 093337777 (no spaces please)
* MOBILE PHONE#
  
  E.g. 021555555 (no spaces please)
* ADDRESS
    E.g. 23 Dominion Road Mt Eden (no commas please)
* EMAIL
   
* TOWN / CITY
OTHER 
   
* DO YOU OWN AN LCD or PLASMA TV?
TV BRAND? 
   
* MOST PREFERRED AUDIO VISUAL DEALER
   
*  I accept the terms & conditions outlined below.
Please send me information about future Samsung promotional offers.
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TERMS & CONDITIONS

1. The Samsung Be in to Win a Digital Camera Every Month begins at 12:01am on 1st January 2009 and ends at 11:59pm on 31st December 2009 (the "Promotion Period").

2. The promoter is Radiola Corporation Limited, New Zealand (the "Promoter").

3. The Promotion is only open to New Zealand residents and limited to one entry per person per month. Employees and agents of the Promoter, its affiliates and subsidiaries, and their immediate families, are not eligible to participate in the promotion. The Promoter reserves the right to request proof of an entrant's eligibility in the event that there is a doubt over his/her eligibility for the Promotion.

4. To enter the Promotion you simply need to fully complete the online entry form. You will then be automatically entered into the monthly prize draw.

5. There is one prize of A SAMSUNG S760 DIGITAL CAMERA per month. Winners will be notified by phone. The prize is not transferable for cash, exchanges or upgrades for other Samsung products will not be accepted. Please allow up to 30 business days once the promoter has verified all necessary entry and delivery details, for delivery of the prize. The promoter reserves the right to substitute products for an item of similar value should out of stock circumstance dictate.

6. The Promoter reserves the right to verify the validity of entries and to disqualify any entrant who tampers with the entry process or who submits an entry that is not in accordance with these Terms and Conditions.

7. Neither the promoter nor any other person or party associated with the promotion shall be liable for any loss or damaged or personal injury suffered or sustained in connection with the promotion.

8. The promoter reserves the right to extend, change or conclude the promotion at any time without notice, should circumstances dictate.

9. The promoter’s decision is final on all matters to this promotion and no correspondence will be entered into.

10. All entries become the property of the promoter only. The information supplied on this redemption form will be kept at the offices of RADIOLA CORPORATION LTD only. If you agree to receive further promotional information via the specified tick box above, the promoter may use this information for the purposes of advising you of future promotions and for other marketing activities carried out by the promoter only.