Keepsake Video Film Transfer Order Form
Please print this form and attach it with your order.

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

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

2. Please mark services requested:

Film transfer to DVD
Film transfer to .avi format (data DVD - NO titles or music)
Film transfer to DV format (miniDV - NO titles or music)
Film transfer to DVCAM format (includes titles and music)
Film transfer to VHS

3. Return Shipping Preference:



4. How many total copies should we produce for you?
DVD
miniDV tape
VHS


5. How did you find us? 

6. Payment options:

Credit Card number:

Expiration Date:    

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


7. Opening Title-please choose one

Precious Memories of the Family -- (fill in family's last name)
Family Memories
Family Memories
Other - PLEASE PRINT CLEARLY on back of form.


8. Closing Title - please choose one

9. Please print and mail to:

Keepsake Video
361 East Parkwood Ave
Friendswood, TX 77546

Questions? Please e-mail us or call:

281-482-2400
or toll free:
888-332-5733

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.  I have read the agreement and submit my order to Keepsake Video in accordance with the preceding terms and conditions:

10. X________________________________________________________Date____________________
Please print this form and attach it with your order.

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