Declaration of Copyright

DECLARATION OF COPYRIGHT:

I, as, [Name and Position] is the author/creator of the work titled, [insert title]. I am authorized to submit this material for inclusion in the [event/compilation/book]. I have authority to convey that all copyright releases and clearances necessary for exhibition/production of the work are secured. I agree that the production of this work will not violate or infringe upon the rights of any person, firm or corporation. I also confirm that the [insert title] is my original work completed during [date].

Signature(s):
[Signature over Print Name]
[Date]
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