Eagle Graphics - Order Form                 Note: Package and Mail all photo

                                            images or video tape cassettes

Date___________                             to:



Name_____________________________________          Eagle Graphics

                                              3546 North Burbank Street

Address__________________________________      Kingman, Arizona  86401



_________________________________________

                                            Please insure your image(s) or

City_____________________________________   photographs for their reasonable

                                            value.  Note the Eagle Graphics

State___________________ ZIP_____________   ships all photo(s) and VCR tape(s)

                                            via U.S. Mail, insured for the

Daytime Phone # ______-_______-__________   default amount set by the U.S.

                                            Post Office.  

Evening Phone # ______-_______-__________



E-Mail address #1 __________________________ Email Address #2____________________  

 Please include your email address so that we can contact you with our estimate

 of charges as soon as we receive and scan your photo(s).



Note: Using the reverse side of this form,  please print  any special instructions

you have for each image or video still order.



                       PLEASE READ THE FOLLOWING BEFORE ORDERING :



          **Copyrighted Photographs MUST be accompanied by Written Release**

          

All  copyrighted  photographs  submitted for repair MUST be accompanied by written

release by the  copyright holder,  if alive,  or if a business, still operating.



                               EXCLUSION OF ALL WARRANTIES:



Customer understands  and agrees that  the implied warranties,  whether statutory, 

expressed, or implied,  are excluded  from this transaction and shall not apply to 

any services or goods sold with the services.



                                LIMITATION OF REMEDIES:



Customer understands and agrees that customer's sole  and  exclusive remedy for any

liability on the part of the retailer or its contractors arising out of or relating

to the services rendered or the goods sold or delivered in connection with services,

or any damage, loss, or  theft of  customer's  negative(s), print(s),  slide(s), or

video tape(s) is to be the purchase price paid by the customer to retailer  for the 

services and the delivery by the retailer to customer of non-exposed film  or like-

quality unrecorded  video  cassette  tape(s)  as  replacement  for any negative(s),

print(s), slide(s), or tape(s).   Retailer  and  its  contractors shall not be held

liable for any other damages,  however demonstrated,  including direct, incidental,

consequential, or special damages. 



                              NO ORAL REPRESENTATIONS:  



Customer represents that  no oral promises,  representations, or warranties  of any

kind have been made by the retailer or its contractors relating to this transaction,

to the services, or to the goods sold or delivered in connection with the services.



Signature________________________________

 Order  must  be signed  by client  before we  may  begin any scan or capture of or 

 repair to any image.