Yes, you download them onto your computer and then you can print them as many times as you wish!!! It is always there in your computer. If you need help with how to download, just email customer service, they are really good about answering!
Once you download them you can print them on cardstock, photopaper, or any other paper your printer will handle. You can adhere them onto chipboard or use them directly on your layout. You can use them to make cards. Some of the E-Cuts are versatel, for instance the example below, E-Cuts were intended for winter and I used them for a summer type photo. Also you can get the book below from the superstore that will help you use the E-Cuts as well.
Print them out and cut them out. You can change the size and print out just the items you want if you copy and paste the items into word. If you have photoshop (I don't) you can do even more to alter them color-wise and stuff. Try printing them on cardstock (white or colored), vellum, transparencies, photo paper (glossy or matte), etc. for different looks. I usually prefer matte photo paper. With my printer it really makes them pop and look more 3-D. Here are some pages where I used them: