Please complete this form and mail it with your check or money order to:

Replay Video Productions
4438 41st St. #4
San Diego, CA 92116

Make your check or money order payable to Replay Video Productions.

VHS - $25
DVD - $25
CD-ROM featuring more than 275+ still photos - $5

Name:

Phone: E-mail address:

I would prefer:

Number of VHS copies: Number of DVD copies:
Amount Enclosed: $
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