Name: ____________________                                   Phone Number: ________________
Please indicate the quantity of each item along with the poses (one pose per size please) you would like to purchase.

           

Items                           Price                                                    Poses

 

___ Package 1             x $15.00 = ________              5x7 _________           (8)wallets _________

 

___ Package 2             x $35.00 = ________              8x10 _________         (2) 5x7 _________(8)wallets _________

 

___ Package 3             x $40.00 = ________              magnet _________     8x10 _________(2)5x7 ________         wallets _________

 

___ Package 4             x $42.50 = ________              11x14 _________       8x10 _________(2)5x7 _________       wallets _________

 

 

___ 11x14                   x $20.00 =________               _______

 

___ 8x10                     x $15.00 = _______                _______

 

___5x7                        x $10.00 = ________              _______

 

___8 Wallets               x $7.50 = ________                _______

 

___ Magnet                 x $7.50 = ________               _______

 

Are you interested in matting and/or framing some or all of your prints?  If so, please see additional charges per item below, and indicate your selection under ‘Special Instructions’ on the back of this order form.

                                  

 Matting                                  Frame

 

11x14                          $12.50                                     $25.00

 

8x10                            $10.00                                     $17.50            

 

5x7                              $7.00                                       $12.50

                                               

                                                                                         Subtotal: ______  

 

                                                            NY State sales tax (8.75%): ______

 

                                                                                               Total: ______

Special Instructions:

 

________________________________________________________________________

 

________________________________________________________________________

 

________________________________________________________________________

 

________________________________________________________________________

 

________________________________________________________________________

 

 

 

 

This agreement is made by and between the purchaser (‘you’, ‘your’) and Ann E. Dudeck d/b/a AED Photographs and Georgetown Animal Clinic, P.C. (collectively ‘AED and GAC’). AED and GAC agree to provide, and you agree to purchase, certain photographic and print services. You further agree that you are purchasing prints of photographic images only; no copyright is transferred hereby. In consideration for the provision of the photography services, you hereby agree that, although all reasonable precautions to protect your safety and the safety of your pet(s) are in place, AED and GAC can not be held liable (jointly or severally) for any injury occurring, to yourself or to your pet(s), during, or after, the photography session, including, but not limited to, injury caused by animals, injury from communicable illness. By participating in a photography session, you further agree that, you understand and accept the terms herein, and represent that your pet has: i. no vicious propensities, whereby it may pose a danger to people and/or other animals, and ii. no communicable illness. You further agree that AED and GAC rely on such representation as to your animal(s) made herein, and agree to provide the photography services on the force thereof. You further agree that, in the event AED and GAC, in their sole discretion, determine your pet(s) is/are not able to participate in a photography session, for any reason, upon direction therefrom, you will immediately remove your pet(s) from the premises, with all reasonable speed and safety, and shall have no claim against AED and GAC arising thereby.

 

 

 

 

______________________________          ____________________

Signed                                                           Date

CASH OR CHECK ONLY

Please make checks payable to ‘AED Photographs’

Please allow 10-14 days for preparation of your order.

AED Photographs and Georgetown Animal Clinic, P.C. thank you for supporting the Pet Emergency Fund.