Keepsake Video Format Transfer Order Form 
Please print this form and enclose it with your order.

1. Please complete form, print and return it with your order:

NAME:
ADDRESS:
CITY: STATE:
ZIP:
HOME PHONE:
WORK PHONE:
E-MAIL ADDRESS:

2. Indicate video format conversion services requested:

From: To:
   
3.Return shipping and handling preference:

4.How many total copies should we produce for you?

5. Payment Options:
Credit Card Number:
Expiration Date:    

Card Security Code: 
Name as it appears on the credit card.

6. How did you find us?

If 'search engine' - which one?_________________

7. Please complete this order form, print and enclose it with your order:

Keepsake Video
361 East Parkwood Ave
Friendswood, TX 77546
Questions? Please e-mail us or call:

281-482-2400
or toll free:
888-332-573

Terms and Conditions: When submitting videotapes, films, slides or any other media to us whether for duplication, conversion, repair, video transfer or for any other reason, client acknowledges and agrees that Keepsake Video and any individual or business affiliated with Keepsake Video shall not be liable for any loss or damage to such materials following receipt and during processing of such materials (even if due to our fault or negligence) and that the client’s sole remedy shall be replacement with a similar amount of blank video tape. Keepsake Video makes no other warranty and assumes no other risk and shall not be liable for any indirect special, incidental or consequential damages resulting from client’s use of our services. This agreement excludes specifically any counteroffers by client including (without limitation) statements of value in excess of replacement cost of a similar amount of videotape or requests for special handling. Client warrants that the videotape, film, photos, slides or other media submitted to Keepsake Video for processing is not protected by a third party copyright owner or if protected, the client has obtained permission of such third party copyright holder to make copies. Client also agrees to protect and indemnify Keepsake Video (or it's assignees) from any costs related to copyright infringement. Shipping and handling charges will be added to your order.  Note: Texas residents please add 8% state sales tax.
I have read the agreement and submit my order to Keepsake Video in accordance with the preceding terms and conditions:

  8. X_____________________________________________________________Date______________________
Please print this form and enclose it with your order.

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