Are you dreaming of a WHITE Christmas this Holiday Season?  Let our team make your dream become a reality! 

Register to win a FREE ZOOM!3® Whitening Treatment.  A $650 Value compliments of Dr. Cornette and Team! 

Drawing will be held on December 1, 2006.  No purchase necessary.  Contestants DO NOT have to be present to win.  ZOOM!3® Whitening System prize is not redeemable for cash. Please complete the entry form below to enter.

Entry Form

Fields marked (*) are required

First Name:	*
Last Name:	*
Address:	*
City:	*
State:	*
Zip Code:	*
Telephone:	*
Email:	*

Redemption value not to exceed $650.00. FREE ZOOM! 3 ® is non-transferable and cannot be combined with any other promotional offer. Must be 18 years of age or older to enter. Void where prohibited. Aesthetic Dental Center of Kentucky is not responsible for loss of information due to technical problems with this entry form. Winner is responsible for transportation to and from all visits for this procedure, winner is responsible for any and all additional charges that may apply in regards to this procedure. Aesthetic Dental Center of Kentucky reserves the right to modify or change the contest rules without notification. By submitting your information with this form you agree to the above statements.