Wedding Video Order Form & Licensing Agreement
Phone: (503) 356-1010
Fax to: (503) 356-2293


First Name: Last Name:
Licensee Company:
E-Mail Address:
Website URL:
City: State/Province:
Country: Zip Code:


If you have any questions, please call (503) 356-1010.

We also offer personalized and customized versions of this video
which can include your company's logo, as well as added pictures from your portfolio.
Prices for customization start at $69.99. For more information contact
Media Memories at (208) 288-0253

Please click in box next to single or multiple play version you wish to apply
to purchase a license for and then complete form, sign and date form, and
Fax To: (503) 356-2293

Single Version

Multiple Version

at $19.99 each (Plays 4 minute video one time)-best for showing during consulations
at $29.99 each (Plays 4-minute video 6 times)-best for bridal shows

Choose Shipping U.S. Mail - $6.00 (within U.S. only)
Method and Charges: Second Day Express Mail - $12.00 (within U.S.)
Overnight Express Mail - $18.00 (within U.S.)
Note: Additional charges will apply if mailed outside the U.S.
TOTAL DUE: Amount authorized to charge against my credit card.
Payment Method:   Visa Mastercard American Express Prepay by Check or Cash
Credit Card Number:_________________________________Expires:___________
This is NOT a secure site. Please print form and then write in your Credit Card number prior to faxing in this Order Form.
Authorized Signature:____________________________ Date: _____________________, 2003
Print Name :____________________________ Title: _________________________


The above Licensee Company, for itself and its owners, partners, employees, representatives, successors and assigns, past, current and future (collectively, the "Licensee"), represents and agrees for the benefit of Final Touch Balloons & Event Décor, WynnLin Marketing Materials, Wynn Bell, Lindy Bell, Media Memories, Jonathan Wray and Darra Wray (collectively the "Copyright Owners") that:

1. The video that Licensee has licensed from the Copyright Owners, entitled "Wedding Décor - A Video Idea Book" (the "Video"), together with all images included in the Video, will remain the copyrighted property of the Copyright Owners.

2. Licensee has licensed from the Copyright Owners the limited right to use the Video as an "Idea Book", and that the Video is to be used for the sole purpose of promoting balloon decorating and may be used only by and for the company listed on this Agreement.

3. Licensee will not copy, sell, or give away any portion of this Video or use the Video for any purpose other than that which is contained in this Agreement.

4. Licensee will not in any way represent to any person, company or entity that any of the ideas, designs or items shown in the Video were created by Licensee, and if asked who designed and/or created the work, will always give Wynn and Lindy Bell (Final Touch Balloons & Event Décor) proper credit.

5. Licensee shall indemnify and hold harmless Copyright Owners and any of their employees, representatives, affiliates, distributors, successors and assigns, from any claim or loss arising from the use of the Video, and/or for any claim or loss arising from any work sold and/or created by Licensee as a result of the use of the Video.

6. Licensee will not use this video for any purpose if Licensee's business location or servicing area is within, or becomes within, 150 miles of Portland, Oregon or Meridian, Idaho.

Date Signed:_____________________ , 200___

Print Name: ________________________________________
Title: ______________________________________________