Photography/Illustration Release Form
Thank you for agreeing to have your photographs or illustrations used in an upcoming book. The agreement you make is between
you and the author listed below. In order to verify that you have agreed to this, the author has been asked to obtain the following
release for the publisher, Schiffer Publishing, 4880 Lower Valley Road, Atglen, PA 19310 (610) 593-1777. (You may call to confirm
this.) Please return it to the author when it is complete.
Your name____________________________________________________________
Business name_________________________________________________________
Address______________________________________________________________
City________________________________________ State________ Zip__________
Phones: Home (_____) _____-_____________Bus.(_____)_____-________________
Email: _______________________________________________________________
Please note: (1) Submitters are responsible for obtaining the necessary rights for the photographs, drawings, renderings, computer
models, etc. If the photograph/illustration was not created by the submitter, permission must be obtained from the copyright owner.
Architectural photographers frequently retain ownership of copyrights to images they create. (2) Submitters are responsible for
obtaining the necessary approvals from building/property owners to publish photographs/illustrations of their properties. (3)
Submitter grants to Schiffer Publishing and the author permission to reproduce photographs or illustrations but there is no transfer of
copyright to Schiffer Publishing or the author. (4) Submitter understands that photographs/illustrations may not be included for
selection and that they may be cropped or resized for publication. (5) Submitter agrees to indemnify and hold harmless Schiffer
Publishing and the author from and against all claims and damages arising out of a breach of these representations.
Initial the appropriate areas:
_____I hereby give permission for photographs or art in my possession to be used in the Schiffer Publishing publication(s) and
in related promotional materials, i.e. excerpts, magazine articles, advertisements, etc. This includes possible use on the cover.
_____I hereby give permission for the author to use photographs taken by me or an employee of the company in the Schiffer
Publishing publication(s) and in related promotional materials, i.e. excerpts, magazine articles, advertisements, etc. This includes
possible use on the cover.
_____I hereby give permission for photographs taken by others to be used in the Schiffer Publishing publication(s) and in
related promotional materials, i.e. excerpts, magazine articles, advertisements, etc. This includes possible use on the cover. I certify
that I am the copyright holder of the photographs or I have permission from the legal copyright holder to use these
photographs/illustrations and publication of these images will not infringe on any copyrights, trademarks or trade secrets held by a
third party.
Publication name (working title)
Author(s) Name
Sustainable Historic Buildings
Scott D. Butcher
Each book differs in design. Sometimes credit is given to the contributor of an item in the photo caption, and sometimes
contributors are listed as a group at the beginning of the book. It is too early to tell which will be used in this book. Some people
prefer not to have their names under the pictured item, and some wish to remain completely anonymous.
Please choose one of the options below:
_____ If the credit is to appear in the caption, credit as follows: _______________________________________
_____ I wish not to have the company or photographer’s name in the photo caption, though it may be mentioned in the
acknowledgments.
_____ I wish the company or photographer to remain anonymous.
Signed _____________________________________________Date ________________
(Submitter or authorized representative of submitting company)