Maui Scribe Quarterly

Release Form:

By submitting my work to Maui Scribe Quarterly [hereafter referred to as 'MSQ'] and its companion website, MauiScribe.com, I understand that I will receive no compensation for my work, whether

MSQ/MauiScribe.com chooses to publish it or not. 

I hereby authorize MSQ/MauiScribe.com to publish my work in its entirety, or to edit the work as it sees fit. 

I hereby certify that I am the author and copyright holder of the work I am submitting to

MSQ/MauiScribe.com (entitled _____________________________________________ ), and indemnify MSQ/MauiScribe.com from any third-party author or entity/entities claiming ownership/copyright of said work.

I certify that I am a resident of Maui for at least six months each year and that I am over 18 years

of age.  [Parental signature must appear if under 18 years of age].

Please print and complete this form.  You can then scan & email it along with your submission to: mauiscribe@yahoo.com.  Alternatively, it may be mailed to: 

Maui Scribe Quarterly ~ P.O. Box 12367 ~ Lahaina, Hawai'i ~ 96761

Printed Name:  ____________________________________________

Age:  ______

Address:  ________________________________________________________________________

Email:  _____________________________________

Phone Number:  _________________________

Title of Submission:  _______________________________________________________

Signature:  _____________________________________________

School (if author is a student):  _______________________________________________ 

Parental Signature (if under 18 years of age):  _______________________________________________