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Donation Release Form

EL SEGUNDO PUBLIC LIBRARY

PHOTO AND DOCUMENT ARCHIVES

DONATION AND RELEASE FORM

 

I, ________________________________________, hereby authorize the non-profit organization, Friends of the El Segundo Public Library Inc., to use donated material(s) as they deem appropriate. I understand that the donated material may be used inside the library use for public access, in future exhibitions, for online web pages, publications, and educational activities. I also understand proceeds generated by the materials(s) for reprint fees are used to support public library programs, books, furnishings, and other Friends of the El Segundo, Inc. sponsored activities.

I am aware that in donating the material, it will be made available for use by Friends of the El Segundo Public Library, Inc, and that individuals may use it for personal use under the “Fair Use” doctrine, of the Copyright Law of the United States (Title 17, U.S. code). In releasing/donating an item, I wave claim to any fees, processing or otherwise, that may be collected in the delivery and/or receipt of the image(s) or item(s).

I authorize Friends of the El Segundo Public Library, Inc at its discretion to provide copies of this material to interested parties.

 

___________________________________________ Date: _______________

(Signature)



Name: ________________________________________________________________

(Print)

Phone Number: Day _________________ Evening: ___________________

Address:______________________________________________________________

City:_____________________________________ State: _____________________

Zip Code:________________


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