Carl F. Sermon Photography

RSL Productions

15651 Camino Del Cerro, Los Gatos, CA 95032-3721

Tel (408) 356-9473

Authorization to Print, Publish, or Re-print photos given to:

_____________________________________________________________________________

(List names of person(s) and/or organization(s) authorized to receive photos of performer(s)).

Venue/Event/Date/of Performance ___________________________________________________

(e.g. Ukrainian Center/Rakkasah East/October 13, 2007/Solo and/or Troupe)

Performer’s Name _____________________________________________________________

Professional Name _______________________________________________________

Name of Troupe __________________________________________________________

Mailing Address__________________________________________________________

City/State/Zipcode ________________________________________________________

Email: ___________________________________ Telephone ___________________________

Photos are stored and retained by Carl F. Sermon, RSL Productions. Unless authorized, photos are not available for sale except to the individual(s) photographed by Carl Sermon, RSL Productions.

Photos on this Photo CD may be uploaded to websites, with photo credit: Photo by Carl F. Sermon. Website link to www.ReelSoundandLight.com appreciated.

I, the performer photographed, hereby give the bearer, named above, his/her legal representatives and/or those assigned, and those acting with his/her permission, or his/her employees, the right and permission to print, use, reuse and/or broadcast and republish photographs, for any purpose whatsoever, including the publication at the bearer’s website .

____________________________________ ________________________

Performer’s Signature Date

Thank you for your order and the opportunity to photograph your performance.

Carl F. Sermon, Photographer RSL Productions, (408)-356-9473

15651 Camino Del Cerro, Los Gatos, CA USA 95032-3721