About You:

First Name: MI

Last Name:

e-mail:

Phone: - Area Code and Phone

City You Live In:

State:

Country (if not USA):

Country Telephone Code (if not USA or Canada):

International: If you are having problems with the form due to the format of your country's information, please type it in this text box:



The following questions cover corporate submissions; check "No" in both questions if you are not representing a company or government agency. If we choose your company's submission,  we will ask for your logo and identify it as a corporate or government submission and link to your homepage. TOP

Do you work for the Department of Tourism? Yes No

Are you representing a hotel chain, auto club, insurance company, restaurant, bazaar, retailer or other corporate/government entity involved in the tourism industry? Yes No

If Yes, Name of Organization:


 

About Your Drive:

Title of your Drive:


Country your Drive is in:

State or province your Drive is located in:

The closest major city to your Drive?

Cross street where your Drive Begins (Streets, City, State/Country)


Cross street where your Drive Ends (Streets, City, State)

How many miles or kilometers
is your Drive: Miles Km

Approximate how long does it take to drive your Drive?

Does your Drive have: (Check all that Apply)

What do you Like Best about your Drive? Is there a special story you'd like to attach (i.e.: My husband proposed to me on the top of this ridge...)(100 words or less): TOP

 

Please describe your Drive: (500 words or less):


What are the verbal directions you would give someone who wants to take your drive? (Use East, West, North or South to indicate Turns.  Left and Right are confusing if a person is going the wrong direction)
View Example in PDF, (Requires Adobe Acrobat Reader)

Are there any additional Comments or instructions you'd like to Include? (100 words or Less):

 

Do you want Couples Company to identify your drive with your name and city should we choose to publish it?  i.e.: Decker Canyon submitted by John & Jane Doe, Santa Barbara   Yes No

Photographs:

Do you own the rights (did you or a member of your family take the pictures) to the photos you are submitting?  Yes  No

Photographs are intellectual property and fall under the copyright protection laws of the United States.  Because of this we cannot accept or use professional photographs without the explicit consent of the person who took them.  You must own the rights to the photos you submit in order to give Couples Company permission to use them. TOP

How many photographs are you submitting (Min. 3, Max. 6)?

Please describe the photos you will be sending (75 characters or less):

Required:
Description Photo #1
Description Photo #2
Description Photo #3

Optional
Description Photo #4
Description Photo #5
Description Photo #6

Is one of these photographs a picture of you or your family?
Yes No

Do you want us to include your personal or family photo with your Drive?  Yes  No

If Yes, What do you want the caption under the photo to read?

How would you Rate the Curves on your Drive using a scale of 1 to 5?  Five = hairpin curves and major switchbacks, 10-15 MPH speed limits on several of these curves and they occur over 50% of the drive. One = none.     Curve Rating:     Stars

Consent and waiver to use your
Sunday Drive submission
by Couples Company:

I hereby grant my expressed permission to Couples Company for the purpose of  utilizing the information contained within this form and any photographs I later submit by mail for the purpose of Sunday Drive and other related features or products created by Couples Company. These uses cover all of Couples Company's current and future formats including translation into multiple languages, online, print, audio or visual media.  I verify that the content submitted is my own and not copied, stolen or borrowed from another person, publication, media or source. TOP

Furthermore I verify that I am at least eighteen years of age and have the authority to enter into an agreement. I understand that I am making this submission without an expectation of compensation now or in the future.  To the best of my knowledge, the information contained within this submission is true and correct.  I understand that my personal information will not be shared or used for any other purpose within Couples Company that does not directly relate to the publishing or reproduction of my Sunday Drive submission.

Do you Agree or Disagree with the above statement? Selecting "Agree" means you grant your permission to Couples Company to use your Sunday Drive and Agree and Understand the terms outlined. 
I Agree   I Do Not Agree

Don't forget to Print the Confirmation Page.
You will see a summary of your input after you hit "Submit"
Print 2 copies of this summary page.