Speaker forms for Web postings (For STP Members Only & no fees)
current form: www.toxpath.org/forms.asp
Speaker Release Form
For Re-Use of Materials in Presentations and on STP Website
In order for STP to make education material available to STP membership, you must obtain permission
from the authors or creators to use any of their materials that may be a part of your presentation. For
instance, if you use photographs, graphics or text from others, you may need permission from them to use
those materials so that we can make your presentation materials available to our membership. Please use
the form on the following page to request permission from the rights holders for such materials (usually
the publisher and/or author).
Release Form Instructions
1. Fill in the addresses of the presenter (your address, if you are the presenter) and the copyright holder,
and provide a description of the material in the presentation. You will need to complete a form for
each copyright release you are requesting.
2. Send the form to the rights holder and request that they review, sign and send the form back to the
presenter.
3. Once the presenter receives the signed form from the rights holder, the presenter has authorization to
use the specified material. Please note that you may be assessed a fee.
4. Maintain a copy of the release form for your records, and attach a copy of the release to your
Permission Agreement and Release Form, and mail, fax or email a copy to STP headquarters.
STP
1821 Michael Faraday Drive, Suite 300
Reston, VA 20190
Fax: 703-438-3113
stp@toxpath.org
Under certain circumstances, you may not need to obtain permission to use materials authored by third
parties. For instance, use of copyrighted material may be considered ‘fair use’ under U.S. copyright law.
However, the scope of ‘fair use’ rights under U.S. copyright law is not easily defined and should be
considered in determining if the material in your presentation requires copyright release. Please see
http://www.copyright.gov/fls/fl102.html for more information.
Please note the distinction between the Speaker Release Form and the STP Permission Agreement Form.
The Speaker Release Form is for you to arrange to use materials from others; it must be signed by you
and the permission grantor. The STP Permission Agreement Form grants STP the right to use your
course materials.
Updated 8.13
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Speaker forms for Web postings (For STP Members Only & no fees)
current form: www.toxpath.org/forms.asp
STP Speaker Release Form
(For Speakers to Use to Obtain Permission from Rights Holder)
Date: ___________________________
From:
Name:
Organization:
Address:
City:
Requester Information
To:
Name:
Organization:
Address:
City:
Rights Holder Information
State:
State:
Zip:
Zip:
I am preparing an educational presentation for the Society of Toxicologic Pathology (“STP”), which will occur on
or about ______________________ at _______________________________, and request permission of the
copyright (or other rights) holder(s) to reproduce the material specified below:
By signing this form, you (the rights holder) grant me (the requester) the right and license to use the materials
noted above in my presentation. Furthermore, you understand and agree that such materials, as incorporated
into my presentation, may be reproduced, distributed, transmitted, and displayed by STP both live, during my
presentation and subsequently on the STP website, (accessible only to STP members) without further
compensation to, or authorization from you.
As consideration for your permission, I agree that suitable credit will be given in the course material; if you have
a preferred statement, please indicate it here.
Your prompt consideration of this request is greatly appreciated. Please sign the release form below, or
send your organization’s standard copyright release form and include the name of the requestor on the
form.
Sincerely yours,
Requestor Name (Signature)
Requestor Name (Print)
I (we) hereby have the right and do grant permission and license for the use of the material specified above for
the purposes specified to Requester and to STP.
Copyright Holder Name (Signature)
Updated 8.13
Copyright Holder Name (Print)
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Speaker forms for Web postings (For STP Members Only & no fees)
current form: www.toxpath.org/forms.asp
STP Permission Agreement Form
For Non-Profit, Educational Use on STP Website
I (the undersigned Course Speaker) hereby grant to STP the limited, non-exclusive rights detailed below in my
oral presentation and/or any written materials I provide (collectively, the “Materials”). All rights not
specifically granted to STP below, however, are reserved to me.
1) The right and license to record, reproduce, distribute, transmit, display, electronically store, and
publish the Materials on or over networks and the Internet via the STP website (for access and use by
STP members only), without further compensation to, or authorization from the undersigned.
2) The right to use my name and voice in connection with the programs or courses and my Materials as
associated with the Materials on or over networks and the Internet via the STP website, (for access
and use by STP members only), without further compensation to, or authorization from the
undersigned.
I (Course Speaker) hereby release STP, its successors, assigns, licensees and contractors from all claims,
demands, causes of action and damages arising out of relating to the exercise of the rights granted to STP
pursuant to this agreement, and I (Course Speaker) waive any and all claims and causes of action it may have
or that may arise against STP, its successors, assigns, licensees and contractors arising out of or relating to this
agreement or the grants specified above. The STP shall not be held liable for any unauthorized access to, or
recording or distribution of live or recorded webinar material.
I (Course Speaker) hereby represent and warrant that: (1) that the Materials are original to the Course Speaker,
or that Course Speaker otherwise has the right to give the presentation and to grant the license(s) above or; (2)
that the Materials are in the public domain or otherwise are freely available for public use consistent with this
Agreement; and (3) that, to the best of my (Course Speaker’s) knowledge, STP’s exercise of its rights under
this Agreement will not infringe upon any other person’s or entity’s copyrights or other proprietary rights. I
further represent and warrant that, should my Materials require permission or authorization for use by STP, I
will obtain all authorizations necessary for the use by STP specified above from the copyright or other
proprietary rights holder(s) of such right(s)* and attach said permissions to this Permission Agreement Form.
My representations and grant of rights, as set out on this agreement, will benefit STP, its successors, assigns,
licensees and contractors.
In consideration for the foregoing grants, STP agrees to give the speaker appropriate credit in all
reproductions, copies, and publications of these materials.
*Speakers who have created the Materials in the course of their employment, including those working for the
U.S. government, its agencies, any foreign government or any other institution are advised to consult with
their respective supervisors if they are uncertain as to whether they can grant the licenses specified above.
Furthermore, the scope of “fair use” rights under U.S. copyright law is not easily defined and should be
considered. See http://www.copyright.gov/fls/fl102.html.
Course
Presentation Title
Course Speaker/Copyright
Holder Name and Signature
Copyright Holder Name (Print)
Copyright Holder Name (Signature)
Date
Please return via mail, fax or email to STP at:
1821 Michael Faraday Drive, Suite 300
Reston, VA 20190
Fax: 703-438-3113 stp@toxpath.org
Updated 8.13
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