Colorado Bandmasters Association
2016 Copyright Report Form
School
Director Name
Completed form MUST be returned with CBA State Entry Form in order for your entry to be accepted. Proof of permission/license to arrange and proof of permission to perform(PTP) must be provided if you are using custom arrangements, have modified published arrangements or original compositions.
NOTE: Each custom arrangement listed must be supported by proof of permission to arrange, including music included in a pre-show segment. All original compositions must include proof of permission to perform from the composer. All licenses are due no later than 30 days prior to your first event performance. Please photocopy form if additional selections must be added. FAILURE TO SUBMIT THIS FORM ALONG WITH COPYRIGHT CLEARANCE DOCUMENTATION, PERMISSION TO PERFORM, ETC. WILL RESULT IN THE BAND NOT BEING ALLOWED TO PERFORM AT ANY CBA SANCTIONED EVENT.
NOTE: Please use the actual names of the songs you are performing.
Name of Composition #1
Public Domain? Yes No Stock arrangement? Yes No
Composer Copyright Owner
Arranger Arranger’s Email
If Custom Arrangement, do you have copyright clearance? Yes No (If yes, please attach license & PTP.)
Name of Composition #2
Public Domain? Yes No Stock arrangement? Yes No
Composer Copyright Owner
Arranger Arranger’s Email
If Custom Arrangement, do you have copyright clearance? Yes No (If yes, please attach license & PTP.)
Name of Composition #3
Public Domain? Yes No Stock arrangement? Yes No
Composer Copyright Owner
Arranger Arranger’s Email
If Custom Arrangement, do you have copyright clearance? Yes No (If yes, please attach license & PTP.)
Name of Composition #4
Public Domain? Yes No Stock arrangement? Yes No
Composer Copyright Owner
Arranger Arranger’s Email
If Custom Arrangement, do you have copyright clearance? Yes No (If yes, please attach license & PTP.)
Name of Composition #5
Public Domain? Yes No Stock arrangement? Yes No
Composer Copyright Owner
Arranger Arranger’s Email
If Custom Arrangement, do you have copyright clearance? Yes No (If yes, please attach license & PTP.)
2011 FALL CHAMPIONSHIPS
Band Director’s Signature______Date______
Electronic Signature Agreement. By selecting the “I Accept” box, I confirm that I am the band director identified at the top of tis form and I am signing this Copyright Report Form electronically. I agree that my electronic signature is the legal equivalent of my manual signature on this form. By selecting “I Accept” I acknowledge that the information provided in this from is true, accurate and compete and that I am submitting as an authorized representative of my band, my school and its administration. I also acknowledge that I understand that my school and I are bound by intellectual property laws and subject to applicable penalties for violation of civil and criminal law.
I Accept (By checking this box you are giving your digital signature and you agree to the terms listed above)