Photography Services Request

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Phone Number* This field is required.
Please enter a valid phone number.
4
Please select up to 4 shoot dates that will work for you and we will look at our schedule to see if we are available. If we are not available on the dates you have chosen, then we can discuss other shoot date options with you. Please note that the photographer is only available on weekend dates.
Date
Day
Month
Year
5
Date option 2
Date
Month
Day
Year
6
Date option 3
Date
Month
Day
Year
7
Date option 4
Date
Month
Day
Year
8
Please select the type of Portrait Session you would like:* This field is required.
Please Select
Please Select
Family Portraits
Couples/Engagement Portraits
Children's Portraits
Senior Portraits
Maternity Portraits
Pet Portraits
Business headshots
Corporate Photography
Musician/Actor
Model Portfolio
Wedding Photography
9
How many people will be in your portrait session?* This field is required.
10
Please choose your preferred shoot location:* This field is required.
Please Select
Please Select
OPPD Arboretum, 108th and Blondo
Omaha Downtown Old Market area
Hotel of choice (For Model shoots ONLY! Hotel costs will be at your expense).
Standing Bear Lake, 132nd and Fort area
Other shoot location in mind (Please speak to photographer for accurate pricing on this.)
11
Will any pets be in the shoot? (Pets are ALWAYS welcome!)* This field is required.
Yes
No
12
Photo edits may take up to several weeks to complete. We do not provide unedited photos without a copyright purchase. Are you ok with waiting a few weeks for your photos to be edited? (Please note that business headshots do not take as long to edit as bigger portrait shoots.)* This field is required.
Yes, I am patient.
No, I want my photos immediately.
13
Are you ready to book your photo shoot session?* This field is required.
Yes, I want to book it now!
No, I am not interested in booking a shoot.
I am not sure yet.
I would like to speak with the photographer first.
14
Valery Photography & Design is not available for WEDDINGS for the year of 2023. We will start taking wedding bookings for Fall 2024 and after. Please select one of the options below.* This field is required.
I am interested in Wedding Photography services for 2023. Therefore, this will not work for me.
I am interested in Wedding Photography services for 2024.
I am interested in Wedding Photography services for 2025.
I am not looking for a wedding photographer, but I am interested in other photography services.
I am not interested at all anymore.
15
To reserve your photography portrait session date, there is a non-refundable retainer fee of $25.00. This retainer fee reserves the date for you. If you need to reschedule your photography session, your retainer fee will transfer to a new date (Please work with the photographer in arranging your date). This retainer fee does NOT reserve wedding dates. For wedding photography, please contact us for details.* This field is required.
I agree to these terms.
16
Book my shoot now. (Optional)
prevnext( X )
My Bag
0
My Bag
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
ORDER SUMMARY
TaxUSD
SubtotalUSD
Total costUSD
Retainer Fee
The retainer fee is non-refundable. The retainer fee holds the date of your planned photography session for you in the photographer's schedule.
$25.00Edit
Back
1
1
2
3
4
5
6
7
8
9
10
Quantity
Total cost $0.00
Payment Methods
Credit Card
First Name
Last Name
Cash App
After submitting the form, you will be redirected to the Cash App Pay to complete the payment process.
17
Please add any details about the photography services that you are interested in.
Should be Empty: