My Newbery at 100 Project Permission Form

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SA9CsV6akkvLIxZLuIoSZV8y9ByLE32LvZ6Moc2bVCwC7CQv7NYpPKs

Welcome and thank you for your interest in participating in the My Newbery at 100 project!

For more information, check out https://www.mynewbery100.web.illinois.edu/.

Any questions? Get in touch with us at mynewbery-100@illinois.edu.

Please complete the form below.

First name:

* must provide value

Last/Family name:

* must provide value

How old are you?
(if you are a parent/guardian, answer for yourself)

* must provide value

I am:

* must provide value

What is your child's full name?

* must provide value

Please review the following.

If you have any questions, you can get more information about the My Newbery at 100 project here: https://www.mynewbery100.web.illinois.edu/info/.

Or contact us with this email: mynewbery-100@illinois.edu.

On the 100 year anniversary of the Newbery Medal, The Center for Children’s Books (CCB) at the School of Information Sciences (“iSchool”) at the University of Illinois Urbana-Champaign is collecting materials for the preservation of young people’s responses to books, which may be used in future research. The aim of this agreement is to request your permission to use your child's submitted artwork/project ("Contribution") which may include your child's likeness, image, content, and voice, for educational and research purposes and, at your discretion, also for public display and archiving purposes as explained below.

You (the “parent/guardian”, as identified below) hereby grant consent and permission to The Board of Trustees of the University of Illinois (“University”) to use the Contribution your child provided by uploading through our project website, as specified below.

By signing this license agreement, you agree that the University may use the content and your child's likeness, image, and voice as incorporated in their contribution for the My Newbery at 100 project archive to be housed in the American Library Assocation at the University, and you confirm that:

1. The Contribution is your child's own original work; your child owns the copyright and to the best of your knowledge the Contribution does not infringe on the rights of third parties, including intellectual property rights and rights of privacy;

2. The Contribution is voluntarily provided to the University without any expectation of future compensation and you waive all claims to compensation;

3. You are the parent or legal guardian authorized to sign on behalf of a person under age 18; You have the right, power and authority to grant the rights provided herein;

4. You understand that the University may at its discretion decide whether or not to include your child's Contribution in any of its research or academic materials and activities;

5. You waive any right to inspect or approve the subsequent use of your child's Contribution by the University, pursuant to this permission form;

6. You grant the University a non-exclusive, free, world-wide, perpetual, irrevocable license to freely use, reproduce, publish, store, host, publicly display, distribute, translate, transmit, make available, and make derivative works of your child's Contribution, in whole or in part, in all forms and media of expression now known or developed in the future for any lawful academic or educational purposes, including but not limited to research and archival purposes and promotional activities, for the Contribution (including image(s), voice, likeness and content) obtained per the above.

7. You further attest that you have read this consent form and fully understand its contents.

May we save your child's project in our archive at the University of Illinois?

An archive is a collection of materials that helps people understand history and traditions like the Newbery Award better. We want to include your child's project because our existing archive about the Newbery Award includes mostly things from adult librarians and authors, and we think youth perspectives are important too. Find more details here: https://www.mynewbery100.web.illinois.edu/info/.

* must provide value

Yes

reset

May we also share your child's project publicly online?

* must provide value

Yes; without their name

Yes; with their first name and last initial

reset

The permission is granted and effective on the date of my signature.

* must provide value

Add signature

Please review the following.

If you have any questions, you can get more information about the My Newbery at 100 project here: https://www.mynewbery100.web.illinois.edu/info/.

Or contact us with this email: mynewbery-100@illinois.edu.

On the 100 year anniversary of the Newbery Medal, The Center for Children’s Books (CCB) at the School of Information Sciences (“iSchool”) at the University of Illinois Urbana-Champaign is collecting materials for the preservation of young people’s responses to books, which may be used in future research. The aim of this agreement is to request your permission to use your submitted artwork/project ("Contribution") which may include your likeness, image, content, and voice, for educational and research purposes and, at your discretion, also for public display and archiving purposes as explained below.

You (the "creator" as identified below) hereby grant consent and permission to The Board of Trustees of the University of Illinois (“University”) to use the Contribution you provided by uploading through our project website, as specified below.

By signing this license agreement, you agree that the University may use the content and your likeness, image, and voice as incorporated in your Contribution for the My Newbery at 100 project archive to be housed in the American Library Assocation at the University, and you confirm that:

1. The Contribution is your own original work; you own the copyright and to the best of your knowledge the Contribution does not infringe on the rights of third parties, including intellectual property rights and rights of privacy;

2. The Contribution is voluntarily provided to the University without any expectation of future compensation and you waive all claims to compensation;

3. You are at least 18 years of age; You have the right, power and authority to grant the rights provided herein;

4. You understand that the University may at its discretion decide whether or not to include your Contribution in any of its research or academic materials and activities;

5. You waive any right to inspect or approve the subsequent use of your Contribution by the University, pursuant to this permission form;

6. You grant the University a non-exclusive, free, world-wide, perpetual, irrevocable license to freely use, reproduce, publish, store, host, publicly display, distribute, translate, transmit, make available, and make derivative works of your Contribution, in whole or in part, in all forms and media of expression now known or developed in the future for any lawful academic or educational purposes, including but not limited to research and archival purposes and promotional activities, for the Contribution (including image(s), voice, likeness and content) obtained per the above.

7. You further attest that you have read this consent form and fully understand its contents.

May we save your project in our archive at the University of Illinois?

An archive is a collection of materials that helps people understand history and traditions like the Newbery Award better. We want to include your ideas because our existing archive about the Newbery Award includes mostly things from librarians and authors. Find more details here: https://www.mynewbery100.web.illinois.edu/info/.

* must provide value

Yes

reset

Would you also like your project shared publicly online?

* must provide value

Yes; without my name

Yes; with my first name and last initial

reset

Which Newbery book(s) is your project about?

Expand

How did you pick this book?

Reading this book was my choice

I was assigned to read a Newbery book, but I chose this title

I read this book because it was assigned

Why did you create the project you're submitting?

I was interested/I wanted to share my work

A friend of mine suggested I submit

An adult suggested I submit

This was an assignment

Anything you want us to know about what you've made?

Expand

Would you be interested in talking to us in the future about what you submit?

Yes

reset

How should we contact you (email, phone number, etc.)?

The permission is granted and effective on the date of my signature.

* must provide value

Add signature

Please upload your project here.

* must provide value

Upload file

Can we save your project in our archive at the University of Illinois?

An archive is a collection of materials that helps people understand history and traditions like the Newbery Award better. We want to include your ideas because our existing archive about the Newbery Award includes mostly things from adult librarians and authors, and we think youth perspectives are important too. Find more details here: https://www.mynewbery100.web.illinois.edu/info/.

* must provide value

Yes

reset

Would you also like your project shared publicly online?

* must provide value

Yes; without my name

Yes; with my first name and last initial

reset

Which Newbery book(s) is your project about?

Expand

How did you pick this book?

Reading this book was my choice

I was assigned to read a Newbery book, but I chose this title

I read this book because it was assigned

Why did you create the project you're submitting?

I was interested/I wanted to share my work

A friend of mine suggested I submit

An adult suggested I submit

This was an assignment

Anything you want us to know about what you've made?

Expand

Would you be interested in talking to us in the future about what you submit?

Yes

reset

How should we contact you (email, phone number, etc.)?

What is your parent/guardian's email?

We will use this to ask for permission for your participation.

* must provide value

Please write your name (use your finger or the mouse/cursor) to confirm you want to submit your work with the details above.

* must provide value

Add signature

Please upload your project here.

* must provide value

Upload file

Thanks for your interest in the My Newbery at 100 project!

In order to be included, we would need your permission to add you/your child's work to the archive. You may do the following:

1) scroll back up to the archive question to adjust your answer

2) submit the survey below to conclude (your/your child's project will not included)

Please check back to see other's projects here: https://www.mynewbery100.web.illinois.edu/.

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.