Picture form
Send us a pic of you with your new vehicle. We would love to post it on our social media pages!
Name
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First Name
Last Name
Phone Number (OPTIONAL)
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Which Empire store did you purchase your vehicle from?
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Empire CJDR of West Islip
Empire Subaru of Huntington
Empire Chevrolet of Huntington
Empire Ford Lincoln of Huntington
Empire Mazda of Huntington
Empire Honda of Manhasset
Empire Toyota of Huntington
New Rochelle Hyundai
Genesis of New Rochelle
Empire Volvo Cars of Smithtown
Instagram (OPTIONAL)
Facebook Link (OPTIONAL)
TikTok (OPTIONAL)
Twitter (OPTIONAL)
YouTube (OPTIONAL)
Snapchat (OPTIONAL)
Email (OPTIONAL)
example@example.com
Tell us about your experience, what you were driving before, and why you chose this vehicle? (OPTIONAL)
Filling out any part of this form hereby authorizes Spin Mgmt CC LLC and those acting pursuant to its authority to: (i) record my likeness and/or voice on a video, audio, photographic, digital, electronic, or any other medium; (ii) use my name and biographical material in connection with such recordings; and (iii) use, reproduce, exhibit, and/or distribute my name, biographical material, and such recordings in any medium (e.g., print publications, video, internet, etc.) for promotional, advertising, educational, and/or other lawful purposes. I release and waive any claims or rights of compensation of ownership regarding such uses and understand that all such recordings shall remain the property of the Spin Mgmt CC LLC. I certify that I am 18 years of age or older or that my parent/guardian has signed below.
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