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Photo Session/Performance Photo Model Release* Order Form

Yaa Halla Y’all Festival 

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                  ($40 ) per performance

  • I wish to schedule a Photo Session at Yaa Halla Festival 

              Thursday Special ($60  solo/duet) ($75  troupes)

              Friday thru Sunday  ($70  solo/duet) ($90  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: _____________