Consent To Create/Publish - Graphics by Hurricane

Please fill out the form below. We will use this form to ensure that we add you in correctly as a user on your new website as well as to ensure that we have your consent to Create, Publish, and Maintain your new website.

Consent To Create/Publish

First Name *

Last Name *

Email Address *

What is the exact domain name you will be using? (example.com) *

What would you like your user name to be? *

What would you like your password to be? (You can change your password after the initial login) *

By Checking The box below, I agree to the specified terms between Graphics by Hurricane (or Hurricane Web Development) and myself. I understand that I am giving my permission for Graphics by Hurricane (or Hurricane Web Development) to Create, Publish, and Manage my website and its contents. *

I agree

I do not agree