Kingdom of Caid, Society of Creative Anachronism, Inc.

Publication Permission Form

This permission form must be printed and signed and forwarded to the appropriate publication. SCA Publications must have your signature on file.

I, (Legal Name) , being known within the Society for Creative Anachronism

as (name and titles) , do hereby grant permission for

the: (Circle appropriate item(s): article / poem / graphic/ song /other ) entitled: ) to be used as follows (check all that apply, complete blanks where necessary)

Ownership by the publication titled and all copyright granted to that publication (or to: Kingdom of Caid of the Society for Creative Anachronism, Inc.), which shall determine all future use of the item named above. (Check no other item.)

One-time publication in an issue of: ), as (please specify limited use if desired, e.g. cover page only or cover page and/or inside artwork—can limit size)

Or publication in that publication no more than times (separate issues)

Performance at the event called
Posting on the Caidan Web page for:
I recognize that persons unknown may link to this site or may use my work without my permission. I shall hold the web page owner harmless from such activity if proper notice appears on the Web page, and I am immediately notified when the link or use is discovered.

If I have checked one of the last four options, I retain all copyright in my work and may grant permission to any other publication or entity to use my work, or may withdraw permission as I choose.

I further certify that I am the sole creator of this work, and have not substantially based it upon the work of any other person. If others have contributed to this work, or if I have based this upon the work of any person, their names and addresses (or other contact information) and the name of the original work are:

Date: //

Signature: (Signature must be on completed and mailed form.)Address”

Address: E-mail Address

Please indicate how you would like your art credit to appear in the publication:

SCA Name: (print):

Legal Name: (print):

Use SCA Name only

Use Legal Name only

Use Both SCA and Legal Name