Breakthrough Visuals Booking Form

Name *

First Name Last Name

E-mail *

example@example.com

Phone Number *

Area Code Phone Number

Shoot request date & time

Number of People in Session *

Children under the age of 16?

Yes No

Child(ren)'s names & ages

What is your creative vision/idea for your shoot?

Select Your Shooter

PORTRAIT AGREEMENT & MODEL RELEASE: I have read and agree to the following statement: I commission Breakthrough Visuals, the photographer, to photograph myself and/or my underage children. I hereby grant Breakthrough Visuals and its legal representatives and assigns, the unrestricted right to use and publish photographs of myself, family, and/or child(ren), or in which myself, family, and/or children will be included for editorial, trade, advertising, and any other purpose and in any manner or medium; to alter the same without restriction; and to copyright the same. I hereby release Breakthrough Visuals and its legal representatives and assigns from all claims and liability relating to said photographs. The photographer respects the clients wishes to not share any photos on social media or website if requested. The Client shall reimburse Photographer for any additional costs the Photographer may incur for travel, meals, parking, and other reasonable costs necessary to the performance of these services. *

I Agree I DO NOT Agree

COPYRIGHT: As a client of Breakthrough Visuals, I acknowledge and understand that the images taken by Breakthrough Visuals, are protected by Federal Copyright Laws. I understand it is ILLEGAL to copy or reproduce these photographs elsewhere without the PHOTOGRAPHER's permission, and violaters of this Federal Law will be subject to its civil and criminal penalties. A PRINT RELEASE is supplied with the purchase of my session digital files to print your portraits for your own personal use. The print release does not allow publication of your portraits (i.e. entering in contests), selling or altering your images without the PHOTOGRAPHER's permission. Reproduction includes, but is not limited to scanning, downloading, right-clicking, emailing, saving to hard drive, posting on websites or blogs, photocopying, obtaining screen shots, or printing in any manner. I agree to honor the copyright laws as stated in this agreement. The session fee is due at the end of the session. When there are more than one session in the package, the full session fee is due at the end of the first. *

I Agree I DO NOT Agree

By submitting this form you certify that You are at least 18 years of age. You have read this portrait agreement/contract and fully understand the contents thereof. You agree that you have the legal authority to grant these permissions and accept all responsibility for such. DEPOSIT INFORMATION A non-refundable deposit is due upon booking in order to reserve your Session. All remaining Balances are due at the time of the session. If the package includes more than 1 session, the remaining balance is due at the end of the first. No part of any order, including proofs, will be delivered until the balance is paid in full. Your time and date are not reserved until the deposit are received full and clear. If the Photographer fails to appear at the place and time specified above, the deposit shall be refunded to the Client. Rescheduling will be arranged if the photographer or her family becomes ill at the time of your session. Re-scheduling of the date due to bad weather may occur at my discretion only. When there is a package that involves more than one session, the full session fee is due the date of the first session. If the photographer cannot be present for the following sessions, the client will receive the calculated session fee.

I Agree I Do Not Agree

Breakthrough Visuals

Client Portrait Agreement/Contract & Copyright