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Release Form - Eugenides Script Writing Competition
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International Planetarium Society

THE IPS EUGENIDES FOUNDATION SCRIPT CONTEST
Release Entry Form

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(Complete one form per script. Enclose with each script by the deadline Dec. 31, 20__)


Submission date: ____________________________________

I the undersigned, do hereby release unto the International Planetarium Society (IPS) the script entitled

_____________________________________________________

I acknowledge that the script released hereby may be published in the IPS’s journal, the Planetarian as well as in the IPS website, that IPS may maintain this script for distribution to its members in digital format and in hard copy form but the script will remain my property to do what I please. I understand that an IPS committee will screen submitted scripts to control duplication of materials and to eliminate known proprietary material.

I, the undersigned, do hereby represent unto IPS that this release is not contrary to any copyright registration or other registration relating to copyright pro­tection with respect to this script, that this release is not in conflict with any other agreement executed by me and I will, to the extent reasonably possible, execute such further assurances of title as may be nec­essary and defend the same.

IN WITNESS HEREOF, I the undersigned have executed this release as of the date first above written.

 

SUBMITTED BY: __________________________________________
(Signature)

SURNAME: _______________________________________________________

FIRST NAME: ______________________________________________________

ORGANIZATION: ______________________________________

ADDRESS: (Street, number) _________________________________________________

(City, State) _________________________________________________

(Zip code, Country) _________________________________________________

TEL. __________________________________________________

FAX _________________________________________________

Email: ____________________________________________________

 

WITNESS: (Signature) _______________________________________

SURNAME: ________________________ FIRST NAME: _____________________________

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c/o Ann Bragg, Treasurer   
Marietta College, 215 Fifth Street   
Marietta, Ohio 45750 USA