Battle Babe Nominee Request

1
Person Nominating* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Phone Number* This field is required.
Area Code
Phone Number
4
Release of Liability:

Battle Babes is a service that helps Dignify A Diva and Secure her bag. Battle Babes is a box filled with goodies picked by Idalia LaPointe herself and packaged for the nominee. We will mail or deliver the goods to the desired address.

We will collect information that will help us pick appropriate products to help the nominee feel her best.

We are not responsible for skin irritation nor allergic reactions that could potentially happen from the spa-like products we will box for the nominee. We recommend reading the ingredients prior to utilizing them to prevent skin irritations from the products.
5
Did you read and understand the above statement?* This field is required.
YESNO
6
Name* This field is required.
First Name
Last Name
7
Email* This field is required.
example@example.com
8
Phone Number* This field is required.
Area Code
Phone Number
9
Favorite Color
10
Any Makeup and / or Food Allergies?* This field is required.
YESNO
11
Tell us why you are nominating this woman to be our Battle Babe!!!* This field is required.
Huge
Large
Normal
Small
Ok
Ok
Should be Empty: