Model withdrawal form

(complete and return this form only if you wish to withdraw from the contract)

• To:
  GALERIA ALASKA PRODUCTIONS / Jochen Hick
  Falkenried 56
  20251 Hamburg
• I/We (*) hereby give notice that I/We (*) withdraw from my/our (*) contract of sale of the following goods (*)/for the provision of the following service (*)
• Ordered on (*)/received on (*)
• Name of consumer(s)
• Address of consumer(s)
• Signature of consumer(s) (only if this form is notified on paper)
• Date