DISCLAIMER: Templates are provided as examples to help you todraft permissions requests and to encourage youto think critically about the rights youmay need for current and future uses. The templates do not constitute legal advice and make no determination, declaration, claim or warranty of rights obtained for any particular scenario.
Scroll down to the next page for the template.
License Template
I, ______, hereby grant The Ohio State University, other affiliates, licensees, successors and assignees(collectively, “University”) a worldwide, royalty-free, non-exclusive, perpetual (for the duration of the applicable copyright) license to make use of and make copies of my speech, presentation, video, and writing in all types of media, as well as any component parts or files in connection with [project/course/conference name.]This license includes the rights for permanent archiving and public access, and to make derivative works, providedthat the University credits my work by name. I understand that giving my permission is voluntary and does not alter the copyright or other rights to the work that I might hold. I understand that this license does not prevent me from entering into similar arrangements with other parties or from exercising any rights that I may have in the work. However, I understand that I may need to inform subsequent publishers or others that I have granted this preexisting permission.
The rights granted to the University may be exercised in all media and formats whether now known or hereafter devised, and include the right to make such modifications as are technically necessary to exercise the rights in other media and formats. I certify that I have obtained proper permission for any third party material used within my work.The University is granted the right to use all of my work in any manner that it deems appropriate.This grant includes any physical or digital educational uses including, but not limited to, inclusion in the Knowledge Bank (The Ohio State University Institutional Repository), exhibition, display, reformatting for preservation and access purposes, and making works available for research and scholarship.
I waive the right to receive any payment for the University’s use of material described in this release.I also waive any right to inspect or approve finished photographs, audio, video, multimedia, or advertising recordings and copy or printed matter or computer generated scanned image and other electronic media.
[Use only if signee is a student]In connection with the use of the work(s) as set forth above, I hereby waive the confidentiality provisions of the Federal Family Educational and Privacy Rights Act of 1974 with respect to the content of the work(s) and with respect to information concerning my authorship of the work(s), including my name and status as a student at The Ohio State University.
I acknowledge that I have read and fully understood the contents of this document, and have freely signed below.
______
SignaturePrinted Name
______
Telephone NumberEmail Address
______
AddressDate
If release is provided on behalf of a minor:
I hereby certify that I am the parent or guardian of [student name], who is under the age of eighteen years, to whom this release applies and that I have the legal authority to execute this release. I approve the foregoing and agree that we both shall be bound thereby.
______
Parent/Guardian SignatureParent/Guardian Printed Name
______
Parent/Guardian Telephone NumberParent/Guardian Email Address
______
Parent/Guardian AddressDate