The Flint Journal Photo Reprint Order Form (one photo per form) Fill out, print, sign and return.

The Flint Journal

FOR INTERNAL USE ONLY

200 East First Street, Flint, MI 48502-1925

Date

www.flintjournal.com/buystuff/photoorderform

To Library

E-mail: photo@flintjournal.com

To Photo

*Signature Required Below

To Cashier

PICK UP MAIL

Address

Phone

City

State

ZIP

Photo Publication Date

Page No.

Photographer’s Name

Photo Caption

Souvenir Photo Packages — for personal use only (choose one)

Color (if available)

Black and White

Package A: 1 - 8 X 10
Package B: 1 - 5 X 7 and 4 wallets

Package C: 2 - 4 X 6 and 3 wallets
Package D: 9 wallets

• First package (choose one)

A    B    C    D

First Package

$

• Additional packages (fill in quantity in box below)

A    B    C    D Total packages

$10 per additional package

$

Payment for all photos must accompany order.

Rush handling fee (within 1 week) $25.00

$

Make checks payable to The Flint Journal.

TOTAL

$

Credit Card

MasterCard    Visa

Expiration Date

Credit Card Number

Name on Credit Card

Photo processing of any picture usually requires 7–14 days. Delivery cannot be guaranteed.
*Depending on original size, photo may not print to the exact size mentioned above.

If approved by The Flint Journal, you may physically display the photo(s) for your own personal use or give your copy of the photo(s) to another, but the photo(s) may not be used or republished by you or others in any other manner or media, print, digital, or otherwise, regardless of how distributed or transmitted, or for any other purpose without our prior written consent, which we may grant or withhold in our sole discretion. You may not copy or reproduce the photograph in any form (graphic, electronic, mechanical, or otherwise, including photocopying and information storage or retrieval systems).

You may not grant to any third party the permission granted to you herein, and any such purported grant of permission shall be null and void. You may not cover nor remove our copyright notice.

The Flint Journal expressly makes no warranties or representations of any nature whatsoever with respect to the rights of persons or owners of property pictured or named in the photograph. You will indemnify and hold The Flint Journal and its employees and representatives harmless from and against any and all liability and claims of any nature that may arise from your use of the photograph. You are responsible for obtaining any required consents and releases that may be necessary for the use of the photograph from third parties, including but not limited to consents from persons who appear recognizably in the photograph(s).

*Signature (required)

Date

Fill out this form and return with payment in person or by mail to:
Cashier, The Flint Journal, 200 East First Street, Flint, MI 48502-1925 or call 810.766.6179
All requests are subject to review and approval by The Flint Journal.