Defiance Photo Session Request

Please provide the following contact information:

Name
Title
Organization
Home Phone
FAX
E-mail
Your Favorite URL

Please identify and describe yourself:

Date of Birth
Sex Male Female  Couple

Requested Arrival Date

-- mm/dd/yy
 

The Type of Photographs I would like taken

Family Photographs   Old West Photos      Outdoors Photos       Boudoir        Fantasy photography     Clothing Optional   
 Other, Please Explain in the above text area
  Do you wish for one of us to be in a photograph with you?
Special Request

Select any of the following options that apply:

Prints
 Photos on CD
 Photos on DVD

Video Session

How many photos do you wish taken  
 

I am 18 Years or older

I understand that I may need to show proof of age and sign the appropriate model release forms before the photo shoot if we decide that it would be necessary.
 

I will be...