RELEASE FORM

PLEASE PRINT CLEARLY. Fill out all fields below in full, or we will be unable to use your work.

Section 1 - Contact Information

Real Name: ___________________________

Phone Number: _____________________

E-mail Address: ___________________________


 

  1. I, the undersigned, have given explicit permission for my submission (listed above) to be used as part of your forthcoming project. I release my material for your use at no charge, and with the understanding that it may be edited for file size and format.
  2. I understand that I retain all copyright and ownership of my material, and agree to allow it to be used as part of your project with no restrictions or expectation of financial compensation, now or in the future. My sole compensation will be in the form of the promotional value of being included in the project only.

  3. I maintain that I alone have the rights to agree to these conditions, and no other party or company owns the rights to the material. I alone have the right to issue this license.

  4. Additionally, I, the undersigned, have given explicit permission for my submission to be used as part of your project with the understanding that it may reproduced in additional media, including, but not limited to, hardcover or softcover publication publication.

  5. I certify that I am the writer/artist of the work being submitted to you. This story, [insert TITLE] here, has not been published previously online or in print and has never been printed in whole or in part on a blog, website or forum or any other medium.

  6. I acknowledge that the submission was written by me (us). I also acknowledge that I (we) am (are) the sole owner(s) of this work and its copyright.

  7. I understand and agree that I will not be entitled to any compensation or other consideration because of the use of such similar or identical material, stories, ideas, and/or concepts that may have come to you or your affiliates. I hereby release you from any and all claims, liabilities and demands that may be made by me asserting that you have used or appropriated the Submission, or any portion thereof.

  8. I also attest that no confidential relationship is established by submitting this material to you.



Signature: __________________________

Date: _______________


 

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