Big read 2013 14 release form

Page 1

Release Form & Information Request

Call of the Wild Dearborn: Animal Tales I give the Dearborn Public Library permission to use all or any parts of these materials for such scholarly and educational purposes as the Dearborn Public Library shall determine are appropriate.

I further agree that the Dearborn Public Library owns all rights to the materials submitted. The Dearborn Public Library may allow me to make use of them.

I recognize that editors may choose to make changes to my submission and will contact me only if the changes are substantial. I acknowledge that title changes are not considered to be substantive changes. I acknowledge that any photos submitted may not be sent back to me.

_____________________________________________________________________ Print Name

___________________________________________ Signature of Participant

_______________________ Date

______________________________________________________________________


Address

______________________________________________________________________ Email Address (if any)

______________________________________________________________________ Phone

I (do or do not) give permission to state my email address in the publication.


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