The University of Arizona Press
P. O. Box 210055
Tucson, AZ 85721-0055
__________________________("Author") has informed me that he/she is researching, writing, and publishing a book tentatively titled____________________________________________ ("the Work"), and has asked me to grant interviews and to otherwise cooperate with Author in connection with the Work.
In order to assist Author in the preparation of the Work, I have agreed to be interviewed and to provide information and other materials to be used in connection with the Work, including my personal experiences, remarks, and recollections, as well as any photographs and documents that I may choose to give to Author ("the Interview Materials").
I hereby grant and assign to Author, and his/her licensees, successors and assigns, the following non-exclusive rights in connection with the Interview Materials for use as part of the Work, or any advertising, packaging, or promotional materials for the Work, in any and all editions, versions, and media, in perpetuity and throughout the world.
In order to enable Author to develop the Work in any manner that Author may deem best, I hereby release and discharge the Author and his/her licensees, successors and assigns, from any and all claims, demands, or causes of action that I may have against them by reason of anything contained in the Work, or any of the above uses, including any claims based on the right of privacy, the right of publicity, copyright, libel, slander, or any other right.
I acknowledge and agree that I am not entitled to receive any form of payment from Author and/or his/her licensees, successors, and assigns.
Agreed and confirmed:
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