"The Fairy
Tale Chronicles" Anthology Parental Consent Form
YOUR KIDS' CREATIONS, a division of Melusine Muse Press
“The Fairy Tale Chronicles" Anthology SUBMISSIONS
PARENTAL RELEASE FORM ON BEHALF OF MINOR AUTHOR
YOUR KIDS' CREATIONS, a division of Melusine Muse Press
“The Fairy Tale Chronicles" Anthology SUBMISSIONS
PARENTAL RELEASE FORM ON BEHALF OF MINOR AUTHOR
I, ________________________________________, am the
undersigned parent or legal guardian (“Guardian”) of_________________________
(“Author”), who has submitted the following
(check all that
apply):
______Short Story
entitled________________________________________________
______Artwork/Illustrations/Drawings
entitles___________________________________________________
______Miscellaneous
entitled_______________________________________________
(Hereinafter,
such submission(s) shall be individually and collectively referred to as
“Work”) for "The Fairy Tale Chronicles" anthology by Your Kids'
Creations, a division of Melusine Muse Press (www.melusinemusepress.com)
("Publisher").
By
the signature below, and for good and valuable consideration herein described,
receipt of which is acknowledged, Guardian hereby:
(1)
Warrants that the work submitted by Author is Author’s own work and content for
which Author holds the copyright;
(2)
Consents to the publication on one or more occasions of Author’s Work in the
anthology by Publisher for the intended purpose and to the editing of the work
for length, spelling and grammatical errors, and content;
(3)
Understands that since the Work is published in the anthology, it will be
disseminated to a number and variety of readers, and Guardian hereby releases
and holds harmless Publisher, its employees and agents, from any obligations
and/or claims of any nature arising from the publication of the Work in the
anthology in either it's print or e-book formats, including, without
limitation, claims of invasion of privacy or defamation, infringement of moral
rights or rights of publicity or copyright;
(4) Agrees that publication of Author’s Work by
Publisher is good and valuable consideration.
By
the publication of Work in anthology, Publisher does not claim any copyright to
the Work nor any exclusive rights to publication. Your Kids' Creations will
properly credit Author with the creation of the Work, either under Author’s
true name or a pen name of Author and/or Guardian’s choosing.
Agreed,
this ____ day of _____________________, 2016 by:
Signature:
_________________________________________ Print
Name: ______________________________________
Relationship:
_____________________________________ Phone/E-mail:_____________________________________
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