Publication Permission Form
Photographer's / Artist's General Release
Society for Creative Anachronism, Inc.

I, , being known within the Society for Creative Anachronism as , do hereby grant permission for (check all that apply:)

to be posted on the Web page located at and/or in the galleries for located at http://galleries.eastkingdom.org.

I recognize that persons unknown may link to this site or may use my work without my permission. I shall hold the web site owner harmless from such activity if proper notice appears on the Web page, and I am immediately notified when the link or use is discovered.

(Check all that apply:) I retain all copyright in my work and may grant permission to any other publication or entity to use my work.

I further certify that I am the sole creator of this work, and have not substantially based it upon the work of any other person. If others have contributed to this work, or if I have based this upon the work of any person, their names and addresses (or other contact information) are:







Date:
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Signature: (Signature must be on completed and mailed form.)
Address: