Waiver and Order Form for DVD [PRICES SUBJECT TO CHANGE WITHOUT NOTICE] Hoosier Boys State endorses this DVD. If you would like to purchase this DVD, please complete this form and bring to registration. If your family is under significant financial strain and you cannot afford $20, we will gladly accept whatever donation you can make at this time. Orders made after registration will be $30.00 I give Hoosier Boys State and DocuSmith permission to film and reproduce the image of (name)________________________.  It is understood that these images will be used only for the Hoosier Boys State Documentary and for possible Boys State promotional work.  The video will not be sold to people outside of the HBS organization and will only be used for HBS purposes. Name of Parent/Guardian (please print)_________________________________ Phone number (____)____________ (Signature of parent/guardian, date) (sign)_________________________________________ Come prepared to have a great experience!   We’ll come prepared to document it! Please print clearly as this may serve as the mailing label. (Name)_____________________________________ (Address)___________________________________ ___________________________________________ How many copies are you ordering? _______________ Please email us for any questions you may have: bsmith14@nd.edu please make check out to DocuSmith One DVD: $20à ($30 after registration)   $____________ Additional copies: $10.00 each: __ x $10 à $___________ Shipping & Handling is Free Donation (from families unable to afford full price) $______________ (ORDERS MADE AFTER REGISTRATION DAY WILL COST $30) TOTAL:$___________________