Artistic Expressions Artwork Permission Request/Release
I hereby give the Artistic Expression the absolute right and permission, in regard to my artwork:
• To publish the art with credit to me (as copyright owner or licensing agent of the material)
for publication in print and web media.
• Possible posting on the Artistic Expressions website, www.artistic-expressions.org
• To use, re-use, re-publish the same in whole or in part, separately or in conjunction with other artwork in any medium, including (but not limited to) illustration, promotion, and advertising.

I hereby release and discharge Artistic Expressions from any and all claims and demands arising out of or in connection with the use of the artwork. I have read the foregoing and fully understand the contents thereof.

If under age 16, adult signature required:
I represent that I am the (father, mother, guardian) of the above named child. I hereby consent to the foregoing on his/her behalf.

Date *
MM
/
DD
/
YYYY
Artist's Last Name *
Your answer
Artist's Age As of 4/7/2017 *
Your answer
Artist's First Name *
Your answer
Title of Work *
Your answer
Address *
Your answer
Your Email Address *
Your answer
Artist's eSignature *
Your answer
Parent's eSignature
Required if student is under age 16
Your answer
School Name *
Your answer
Your Art Teacher's Name *
Your answer
Your Art Teacher's Email Address *
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.