click here for Word version of YOUTH POETRY RELEASE FORM
click here for PDF of YOUTH POETRY RELEASE FORM

click here for Word version of YOUTH POETRY RELEASE FORM in Spanish
click here for PDF of YOUTH POETRY RELEASE FORM in Spanish

click here for Word version of POET TEACHER POETRY RELEASE FORM
click here for PDF of POET TEACHER POETRY RELEASE FORM

(also, click here for a sample of how to ask youth & their parents to fill out the Youth Poetry Release Form)
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California Poets in the Schools
1333 Balboa Street, Suite 3
San Francisco, CA 94118
Phone: 415.221.4201        Fax: 415.221.4301       Email: info@cpits.org

CALIFORNIA POETS IN THE SCHOOLS
STUDENT POETRY RELEASE AGREEMENT

THIS AGREEMENT, effective as of the date indicated below, is by and between CALIFORNIA POETS IN THE SCHOOLS, a California nonprofit corporation (“CPITS”), and (“POET”), a minor child, by and through Poet’s parents or legal guardian, based on the following:

CPITS is a culturally diverse, nonprofit, educational program whose mission is to benefit children, poetry, and creative expression; and

POET is the sole, exclusive, and original author of various artistic and creative expressions that may include, but are not limited to, poems, writings, visual work, and other similar depiction in any form or medium (collectively referred to herein as “Original Work”). Poet has not copied in whole or in part the work of another.; and

CPITS desires to publish the POET’S Original Work in the publication and/or production of individual or various projects put forth by CPITS in the future ; and

POET desires that CPITS publish POET’s Original Work in the publication and/or production of individual or various projects put forth by CPITS in the future ; and

BASED ON THE FOREGOING, THE PARTIES AGREE AS FOLLOW:

1. POET grants CPITS the royalty-free, non-exclusive right to publish POET’s Original Work, or any modifications of the Original Work, in publications and productions of CPITS’s choosing.

2. Except as provided herein, POET is the sole owner of any copyrights to POET’s Original Work, and POET retains all rights to reproduce, distribute, perform, or display the Original Work along with all other rights, privileges, and remedies granted or reserved to a holder of a United States copyright. POET does, however, grant CPITS the right to license others to publish POET’s Original work, as a means of carrying out the mission of CPITS, except that all such licenses granted shall be of a non-exclusive nature.

3. POET will receive a copy of the ______ CPITS Anthology from CPITS as consideration for POET’s grant of rights in the Original Work.

4. Poet agrees that if the Poet's work is discovered to be copied in whole or in part that the Poet will forfeit the right to have his or her work published by CPITS in the future. Poet agrees to indemnify and hold harmless CPITS, its Board members, officers, employees and agents from any claim, legal action or discipline, including any and all costs and attorney’s fees, brought as a result of the Poet copying another's work in whole or in part.

BY SIGNING BELOW, I HEREBY ACKNOWLEDGE THAT THE WORK IS MY SOLE, EXCLUSIVE, AND ORIGINAL WORK AND I HAVE READ THIS AGREEMENT AND AGREE TO BE BOUND BY EACH AND EVERY TERM HEREIN.

By:________________________________ Dated______________________,______
Signature of Parent or Legal Guardian

Address______________________________

City________________State____Zip____ Phone (_____) __________________

Parent’s email address_______________________________________________
                                      
                                        CPITS POET TEACHER:
By: “Poet”____________________________ _____________________________

Address_____________________________________________________________

City__________________State_____Zip______ Phone (____)______________

Poem’s Title:________________________________________________________

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California Poets in the Schools
1333 Balboa Street, Suite 3
San Francisco, CA 94118
Phone: 415.221.4201        Fax: 415.221.4301       Email: info@cpits.org

CALIFORNIA POETS IN THE SCHOOLS
POET TEACHER POETRY RELEASE AGREEMENT

THIS AGREEMENT, effective as of the date indicated below, is by and between CALIFORNIA POETS IN THE SCHOOLS, a California nonprofit corporation ("CPITS"), and individual ("POET") based on the following:

CPITS is a culturally diverse, nonprofit educational program whose mission is to benefit children, poetry, and creative expression; and

POET is the sole, exclusive, and original author of various artistic and creative expressions which may include, but are not limited to, poems, writings, photographs, visual work, and other similar depiction in any form or medium (collectively referred to herein as "Original Work"); and

CPITS desires to publish the POET'S Original Work in the publication and/or production of individual or various projects put forth by CPITS from time to time; and

POET desires that CPITS publish POET'S Original Work in the publication and/or production of individual or various projects put forth by CPITS from time to time; and

NOW THEREFORE, BASED ON THE FOREGOING, THE PARTIES HEREBY AGREE AS FOLLOWS:

1.      POET hereby grants CPITS the royalty-free, non-exclusive right to publish POET'S Original Work, or any modifications of the Original Work, in book and web publications and other productions of CPITS's choosing.

2.      Except as expressly stated to the contrary herein, POET is the sole owner of any copyrights to POET'S Original Work, and POET retains all rights to reproduce, distribute, perform, or display the Original Work along with all other rights, privileges, and remedies granted or reserved to a holder of a United States Copyright. POET does, however, grant CPITS the right to license others to publish POET'S Original Work, or modifications of the Original work, as a means of carrying out the mission of CPITS, except that all such licenses granted shall be of a non-exclusive nature.

3.      If said work is chosen for the anthology, POET will receive a copy of the CPITS Anthology from CPITS as consideration for POET'S grant of rights in the Original Work.

BY SIGNING BELOW, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AGREEMENT AND UNDERSTAND AND AGREE WITH EACH AND EVERY TERM HEREIN.

By:_______________________________________________Dated_____________,___

Signature of "POET"_____________________________________________________

Address:__________________City _____________ State _____

Zip____________ Phone: (__) ___________________

     
Poem/Work's title:____________________________________________________________________________