Material Release Form

Ethnic Studies Virtual Archive Project

California Polytechnic State University

PREAMBLE

The goal of this project is to preserve historical materials relevant to the California Central Coast’s diverse ethnic communities. By preserving copies of these primary historical materials in digital format, we hope to encourage research on understudied cultural histories.

This collection project is being conducted by the Ethnic Studies Department at California Polytechnic State University (“Cal Poly”) in collaboration with the Filipino American National Historical Society, California Central Coast Chapter (“FANHS-CCCC”) and the Guadalupe Cultural Arts and Education Center (“GCAEC”). Cal Poly is a state agency. FANHS-CCCC and GCAEC are not-for-profit public benefit corporations.

1. PARTIES: This agreement is made by and between __________________________ (“Contributor”) and Cal Poly.

2. MATERIALS: I submit the following Material(s) to be photographed and/or scanned:________________________________________________________________________________________________________________________________________________________________________________________________________

Detailed description and/or images may be attached as necessary.

3. GRANT OF RIGHTS: I grant permission to California State University (“CSU”), its employees and agents, to take and use visual/audio images of any Materials I have presented. Visual/audio images are any type of recording, including photographs, digital images, drawings, renderings, voices, sounds, video recordings, audio clips or accompanying written descriptions. CSU may use such copies of my Materials worldwide in any way to meet its objectives, including: exhibit, publish, reproduce, digitize, modify, use on internet and distribute in perpetuity and in any media whether now known or hereafter created, in whole or in part without my prior approval.

4. RELEASE: I release CSU and its employees and agents, including any firm authorized to publish and/or distribute a finished product containing copies of the Materials, from any claims, damages or liability which I may ever have in connection with the taking of use of the images or printed material used with the images.

5. AUTHORITY: I hereby represent that I have authority to grant the rights described in this agreement.

6. CREDIT: Cal Poly agrees to credit Contributor as is reasonable and customary in educational and scholarly usage. No other consideration will be provided.

7. ASSIGNMENT: Contributor agrees and understands that Cal Poly may assign its rights under this agreement to third parties for educational and scholarly purposes.

AGREED:

CONTRIBUTOR

__________________________ _____________

Printed Name Date

__________________________ ___________________________________

Signature Telephone and/or email address

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