Magic Memories Video Scrapbooks
P.O. Box 213
Champlin, Mn 55316
612-868-3463 voice
www.magicmemories.com
To copyright holder :___________________________________________________
Address : ___________________________________________________________
Magic Memories is in the business of producing Video Scrapbooks which are made by blending photos, video clips, and other materials with music on video tape, and
Our customer :______________________________________________________
Address
:__________________________________________________________
wishes to include the following material in their Video Scrapbook which you and/or
your company holds a copyright interest.
The material consists of [ ] Photo [ ] Video
Clip [ ] Music Clip [ ] Other
Description :
Please be advised that this is a "single use" request for copyright release, for the specific material identified above, and only for the one time personal use of the customer in this specific Video Scrapbook. The copyrighted material will not be reproduced in any other way, and it is understood that the original copyright remains with you and/or your company and is in no way diminished by this one time release.
I hereby grant a one time release of copyright
for the above itemized material for single use in a personal Video
Scrapbook. Beyond this single use, these materials may not be reproduced
in any other form and may not be offered for resale in any manner whatsoever.
I hereby represent that I have the authority to
provide this one use copyright release for the above itemized material.
____________________________________________
Signature of Authorized Representative Date
Please return this signed completed form to Magic Memories
at the address or fax number indicated above.