Vivani Organic Chocolate Contact Form

Your Name (required)    


Your E-Mail (required)    


Year of Birth (required)    


Please attach your photo here to be added to our Vivani lovers and entered into our monthly drawing for 10 free Vivani organic chocolate bars. (photo file must be in jpg, jpeg, gif, bmp, or png format with a max size of 512 kb or 0.5 mb)

Your Photo    
(required with photo)
By checking the box you agree to the terms of our
Photo Release Agreement
InterNatural Foods
Photo Release Agreement

You hereby grant permission to InterNatural Foods to use your name and/or photographs on this website without further consideration. You waive any right to inspect or approve any alterations that may be necessary, including written copy that may be created in connection with your photo submission. You also acknowledge that InterNatural Foods may choose not to use your photograph and/or name at this time, but may do so at a later date. You understand that once an image or name is posted on the Panda Licorice website, the image can be downloaded by any computer with Internet access. You agree to hold InterNatural Foods harmless from any claims related to the use of this information or image. This authority will remain in place unless a written withdrawal is submitted to InterNatural Foods. The date of your submission will be the effective date of this agreement.
and acknowledge that you are at least 18 years of age or in the case of a minor you are the parent/guardian.

Please enter your location here so we can add it to our map. Also, if you would like to leave us a little message we would love to hear your thoughts.
By submitting your message you are agreeing to receive correspondence from InterNatural Foods from time to time. Don’t worry we will never sell, trade, or otherwise transfer your personal information to outside parties as described in our privacy policy. In addition, we respect the right of child privacy and will not accept information from anyone under the age of 14.