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GNSI MURAL RELEASE FORM

 

 

____________________________________    Artist's Name

 

 

Signature of this form grants consent of the adult individual named below (the artist) or, if artist is a minor, the legal guardian, to allow use of any images contributed to or produced during the Guild of Natural Science Illustrators (GNSI) event* listed below, for publication. In addition, the artist grants full ownership of the physical original work to the GNSI (to display, dissect, sell, archive or otherwise dispose of).The artist also gives consent for non-exclusive use, re-use, publishing and otherwise reproducing and displaying these images, individually or in conjunction with other images, writing, photos and video for promotion, art, advertising, and any other purpose whatsoever that relates to GNSI promotion, events, activities and grant reporting. The artist retains the rights to reproduce and use their image contributed to or produced during the event in anyway they see fit.

 

I hereby release and discharge GNSI from any and all claims and demands arising out of or in connection with the use of these images and the physical original, including and without limitations any and all claims for libel or invasion of privacy. This authorization and release shall also inure to the benefit of the successors, legal representative, and assigns of GNSI.  

 

*The event: “California Kelp Forest Chalk Murals” was held and the images created at the University of California, Santa Cruz campus on Monday, July 4, 2016.

 

I have read the foregoing and fully understand the contents thereof. This release shall be binding upon me and my heirs, legal representatives and assigns.    

 

 

___________________________________      _________________________________

Artist’s Printed Name                                                                Date

 

___________________________________

Signature

 

 

___________________________________Address__________________________________City, State, Zip

 

 

I, _____________________, being the parent or guardian of the above named minor, hereby consent to and join in the foregoing release and consent on behalf of said minor. 

 

___________________________________      _________________________________

Printed Name                                                                 Date

 

___________________________________

Signature

 

___________________________________Address__________________________________City, State, Zip

 

 

Please return this form to Taina Litwak, (co-coordinator GNSI California Kelp Forest Chalk Murals project)

 

Taina Litwak                                        or         [log in to unmask]

13209 Chestnut Oak Drive

Darnestown MD  20878                                               

________________________________________________

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