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Photo Session/Performance Photo Model Release* Order Form
Yaa Halla Y’all Festival 2011
Carl Sermon Photography
Reel Sound and Light Productions
15651 Camino Del Cerro, Los Gatos, CA USA 95032-3721
Tel (408) 356-9473
Your photo(s) may appear at the official Event website for this performance, therefore a signed Model Release is required. I hereby give the photographer, his legal representatives and/or those assigned, those for whom the photographer is acting, and those acting with his permission, or his employees, the right and permission to copyright and/or use, reuse and/or broadcast and republish photographs of me, or in which I may be distorted in character, or form, in conjunction with my own or fictitious name (AKA also known as), on reproductions thereof in color, or black and white made through any media by the photographer at his studio or elsewhere, for any purpose whatsoever, including the use of any printed matter or publication at a website in conjunction herewith.
__________________________________________ _________________________________
Model Release Signature (troupe signatures on back) Date
(Your signature and contact information below on this photo release is not a commitment to purchase photos.)
Dance Name/AKA ___________________________________________________________________
Name of Troupe _____________________________________________________________________
Mail to Name _______________________________________________________________________
Mailing Address _____________________________________________________________________
City/State/Country/Zipcode ___________________________________________________________
(In case photographer has questions)
Telephone_______________________Email __________________________________
Your Performance Photo/Photo Session CD order includes 15 to 30 (or more) high resolution photos, a personalized CD label, and a photo usage authorization release signed by the photographer, mailed to you within four weeks. You may reproduce, print, or upload your photos to websites with photo credit (Photo by Carl Sermon). Website link to Reel Sound and Light Productions appreciated for photos published at websites. Photos taken are stored, retained, and on file with Carl Sermon, Reel Sound and Light Productions; and upon request can be sent to publishers. For special orders contact Reel.Sound@comcast.net (408) 356-9473
- I
wish to order my Performance (or troupe) photos on a Photo CD ($35 ) per performance
- I wish to schedule a Photo Session at Yaa Halla Festival
Thursday Special ($50 solo/duet) ($70 troupes)
Friday thru Sunday ($65 solo/duet) ($85 troupes)
¨ Prepayment secures photo session time and pre-festival discount rate – call with credit card (408) 356-9473
- Photo sessions schedule available at www.ReelSoundandLight.com
Day
Time
Amount
Photo Session
$
Costume Description
Performance (1)
$
Costume Description
Performance (2)
$
Costume Description
Performance (3)
$
Costume Description
Total Amount
$
Return this signed order form by mail with your check ( payable to Reel Sound and Light Productions), or as an attachment and credit card info to: Reel.sound@comcast.net
Mail to: Reel Sound and Lght Productions 15651 Camino Del Cerro, Los Gatos, CA USA 95032-3721
VISA/MC #____________-___________-_____________-___________
Expiration Date: _____________ 3 digit code on back of card: _____________