NameCLIENT INFORMATION Full Name * Address * Address 2 (if needed) City * State * - Select Province/State -AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon ====================AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code * Phone Number * Alt Phone Number Email *  FULL NAMES OF ALL PARTICIPANTS (including main contact) BEING PHOTOGRAPHED, Email (if applicable), AND DATE OF BIRTH: (To get specific year faster on date of birth picker, click on the current month until you see the year). add_names_1 add_names_2 add_names_3 add_names_4 add_names_5 Email1 Email2 Email3 Email4 Email5 dob_1 dob_2 dob_3 dob_4 dob_5 ADDITIONAL COMMENTS/SPECIAL REQUESTS:SESSION INFORMATION What type of Session? * Family High School Senior Fashion Maternity Engagement Couple Other If other specify here: Session Location/Address: * Session Date * Start Time (Please specify AM/PM) * Total Hours * TERMS & CONDITIONSI understand Ciril Mathew Photography (hereinafter referred to as "Photographer") is the exclusive official photographer retained to perfom the photographic services requested on this Contract.Upon signature, the Photographer shall reserve the time and date agreed upon. Unless the Photographer is able to fully replace the canceled reservation, all sitting fees and retainers are non-refundable, even if the portrait is rescheduled or canceled for any reason other than inclement weatherIf, in the opinion of the photographer, inclement weather or other adverse conditions prevent the creation of a portrait meeting the artistic standards of the studio/photographer, photographer may elect to use an alternate location or to reschedule the portrait.No part of any order, including previews, will be delivered until the balance is paid in full.The Studio/Photographer reserves the right to use images created under this contract for advertising, display, publication or other purposes. The Client signing this contract warrants that he or she has actual authority to agree to the use of the likeness of all persons included in the portrait in this manner and shall indemnify and defend the Photographer in the event of litigation arising out of such use. Negatives, digital files and previews remain the exclusive property of this Photographer. Photographer may substitute another photographer to take the photographs in the event of Photographer’s illness or of scheduling conflicts. In the event of such substitution, Photographer warrants that the photographer taking the photographs shall be a competent professional.If the Photographer cannot perform this Contract due to fire or other casualty, strike, act of God, or other cause beyond the control of the parties, or due to Photographer’s illness or emergency, then the Photographer shall return any deposit or sitting fee to the Client but shall have no further liability with respect to the Contract. This limitation on liability shall also apply in the event that photographic materials are damaged in processing, lost through camera or media malfunction, lost in the mail, or otherwise lost or damaged without fault on the part of the Photographer. In the event the Photographer fails to perform for any other reason, the Photographer shall not be liable for any amount in excess of all monies paid.Client is aware that color dyes in photography may fade or discolor over time due to the inherent qualities of dyes, and Client releases Photographer from any liability for any claims whatsoever based upon fading or discoloration due to such inherent qualities.The charges in this Contract are based on the Photographer’s Standard Price List. This price list is adjusted periodically and future orders shall be charged at the prices in effect at the time when the order is placed.NOTICE OF COPYRIGHT: It is ILLEGAL to copy or reproduce these photographs elsewhere without Photographer’s permission, and violators of this Federal Law will be subject to its civil and criminal penalties.This Contract incorporates the entire understanding of the parties and is governed by the laws of Pennsylvania. Any modifications of this Contract must be in writing and signed by both parties. I have read and understood the terms above. I hereby agree to the terms of this agreement. I have read and understood the terms above. I hereby agree to the terms of this agreement.