Foreign Tape to DVD Order Form
  Print this form out, fill in, sign and send with your check or money order to:
High-Tech Productions   699 NW 9th Ave.    Boca Raton, FL 33486
Orders will be processed and shipped within 24 hours.

Cost of conversion:

$29.95 + $6.75 shipping & handling            Total = $36.70 per tape

* Florida residents add 6.5% sales tax to total of order.

Please print clearly

Name__________________________________   Phone # (               ) ____________________

Company______________________________________________________________________

Address________________________________   City____________  State____  Zip_________

If paying by credit card,  Account #________________________     Exp. Date______/______

3 or 4 Digit Bank Code on Card:________

Please read and sign.   I hereby authorize High-Tech Productions to transfer this video tape to a DVD. I own all rights to the video being sent in for conversion and will not hold High-Tech Productions liable for copyright infringement. I assume full responsibility for obtaining model releases when required for sale and distribution. Foreign movie conversions are for my private viewing only and not for distribution or resale. I hereby agree that the handling, processing and packaging of all videos is without warranty or liability, even though defects, damage or loss by negligence or other fault may occur, furthermore, I agree to hold harmless and indemnify High-Tech Productions for any and all liability and/or claim arising from this transaction.

Authorized signature___________________________________________  Date____/____/____

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