Collector Release Form
I,________________________________________________________, am documenting folklore. I understand that one purpose of this documentation is to collect folklore that may be deposited in the permanent collection of the Jack Horntip Collection (hereinafter "JPC"). The deposited materials may be used for scholarly and educational purposes and may be duplicated. I understand that the the Jack Horntip Collection plans to retain the product of my participation as part of its permanent collection and that the materials may be used for exhibition, publication, presentation on the World Wide Web and successor technologies, and for promotion of the institution and its activities in any medium.
I hereby grant to the JPC ownership of the physical property delivered to the JPC and the right to use the property that is the product of my participation (for example, my collection or photographs) as stated above. By giving permission, I understand that I do not give up any copyright or performance rights that I may hold.
I also grant to the JPC my absolute and irrevocable consent for any photograph(s) provided by me or taken of me in the course of my participation in the course to be used, published, and copied by the JPC and its assignees in any medium.
I agree that the Jack Horntip Collection may use my name, video or photographic image or likeness, statements, performance, and voice reproduction, or other sound effects without further approval on my part.
The Jack Horntip Collection is used by students and scholars, who may duplicate archived material and may quote it in published form with the permission of the Collection. Scholars using archived material in their studies, research, and publications must agree to give proper credit to the collector, informant, and the Archives, or to protect the anonymity of both collector and informant.
I release the Jack Horntip Collection and its assignees and designees, from any and all claims and demands arising out of or in connection with the use of such documents, recordings, photographs, including but not limited to, any claims for defamation, invasion of privacy, or right of privacy.
ACCEPTED and AGREED
Signature ____________________________________________ Date _________________
Printed Name _______________________________________________________________
Signature of Parent or Guardian (if interviewer is a minor)____________________________ Date_________________
Address _____________________________________________________________________
City ______________________________________________ State ___________________ ZIP _________________
Telephone (______)_______________________________
Relationship, if any, to informant ______________________________________________________________________
Restrictions:
( ) No further restrictions
( ) See below for further
restrictions:
(If none are listed, it is assumed there are no restrictions.)
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
Thank you for participating in the Jack Horntip Collection project. By signing this form, you give your permission to include the collected materials (for example: tapes, photographs, documents, transcripts or interview notes) in a public archive, where they will be available to researchers and the public for scholarly and educational purposes, including publications and exhibitions. By giving your permission, you do not give up any copyright or performance rights that you may hold. The collector(s) and the informant(s) retain the right of free access to the collection through normal procedures of the Collection and its personnel.
I, _______________________, agree to such uses of
these
(Collector -- please print name)
materials as described above,
contribute and hereby release my folklore collection,
____________________________________________ ,
(Title and Number
of the Collection)
to the Jack Horntip Collection.
Signature ____________________ Date______________
Permanent
address (and telephone number) through which you could be reached: