Kids Public Radio
Release Form
Your name:
Your address:
Your phone:
Your contact phone, publishable on the web, if different (800 number, etc):
Your email:
Your website URL:
ASCAP? BMI? SOCAN?
I hereby give the Kids Public Radio, Jabberwocky, Lullaby, and Pickleberry Pie Inc., permission to use portions of my wholly-owned recordings, audio productions, artwork, and/or written comments ( list here)
on its website and in broadcast for public information purposes. I certify that I am the copyright owner of these recordings. I retain all rights to this material.
_________________________
your signature
______________
date
If under 18, please have parent sign permission here and date.
__________________________
Parent signature
______________________
date
Send to: PO Box 1749
Koloa Hawaii 96756 USA
Thank you