Please fill out and submit the following form to allow CLP Nation to create promotional materials using your artwork that is popular with our viewers.

Artist Name

Song Title

E-Mail Address

Without expectation of compensation or other remuneration, now or in the future, I hereby give my consent to Carmel Labs Productions, LLC (d/b/a CLP Nation), its affiliates and agents, to use my image and likeness in its publications, advertising or other media activities (including the Internet). This consent includes, but is not limited to:

(a) Permission to use my name (“Artist Name”), photograph(s), listed audio recording(s) and/or video footage (“Song Title”) in part or in whole, in its publications, in newspapers, magazines and other print media, on television, radio and electronic media (including the Internet), in theatrical media and/or in mailings for education and awareness.

This consent is given in perpetuity, and does not require prior approval by me.

E-Signature (Full Name)

Today's Date

cover image via freepik