COPYRIGHT RELEASE FORM FOR WRITTEN WORK, IMAGES, …

COPYRIGHT RELEASE FORM FOR WRITTEN WORK, IMAGES, ARTWORK

I hereby grant to JOHNSON COUNTY COMMUNITY COLLEGE permission to use the following copyrighted material (listed below) in digital format. I am granting the college permission for non-exclusive rights to use the written work(s), image(s), and/or art object(s) described below in this and future editions of the following project: Project Name _________________________________________________ Description of Copyrighted Material

I certify that no other individual or parties hold copyright interest in the work(s) described above, that I hold all rights to the works listed, and that the license granted herein does not violate any third-party rights or applicable laws. I hereby certify and covenant that I am of legal age (a parent or legal guardian must sign for a minor), or if applicable, that I am authorized to sign on behalf of the entity listed below. Printed Name _____________________________________________________ Signature _________________________________________________________ Date ____________________________________________________________ Street Address _____________________________________________________ City, State _______________________________________________________ ZIP Code _________________________________________________________ Phone Number ____________________________________________________ Email Address ____________________________________________________

R 4/15

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download