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									                                NC AWWA-WEA

NC AWWA-WEA Name of Event: ____________________________________________
Date of Event: ___________________________________________________________
NC AWWA-WEA Event Location: ____________________________________________
Presenter: ______________________________________________________________
Presenter’s Title: _________________________________________________________
Presenter’s Employer: _____________________________________________________
Specific Description of the Work (title and brief description): ______________________

As used herein, the term “Work” shall mean and include the work identified above, the
oral presentation of the work, the Presenter’s comments made in connection with the
presentation of the work, and all written versions of the work as submitted by the
Presenter to NC AWWA-WEA by whatever means, whether such work is submitted
before or after the date of this Acknowledgment, and all parts of the work. As used
herein, “Presenter” means one of the authors of the Work and/or the person who will
present the Work at the Conference; if there are multiple authors or presenters, each
such Presenter shall complete and sign this Acknowledgment.

Presenter represents and warrants that: (i) Presenter is the sole author of the Work,
except as noted as follows:

(ii) Presenter is the original creator of the Work, with the exception of any other author
referenced above, and with the exception of any parts of the Work that are specifically
identified in the Work as being the work of another person; (iii) for any parts of the
Work that are specifically identified in the Work as being the work or another person,
Presenter has obtained written consent and permission to use such person’s work for
the purposes for which Presenter is using and intends to use the Work in connection
with NC AWWA-WEA’s conference and otherwise; (iv) the Work, including the use of the
Work by Presenter and by NC AWWA-WEA as contemplated herein, does not infringe
upon the copyrights or property rights of another person; (v) to the extent the Work
was prepared by Presenter as an employee as a part of Presenter’s job, or would
otherwise be deemed a “work for hire” by a court of competent jurisdiction, Presenter
has obtained the prior written consent of Presenter’s Employer named above to use the
Work and therefore has the capacity and authority to enter into this Acknowledgment
for and on behalf of Presenter and Presenter’s Employer; (vi) the Work does not and will
not defame, libel, slander, harm or injure NC AWWA-WEA or any third party.

Presenter hereby agrees to indemnify and hold harmless NC AWWA-WEA, its officers,
trustees, directors, members, insurers, agents and attorneys from and against any and
all claims, demands and costs, including reasonable attorneys fees, arising out of or
relating to Presenter’s breach of any of the foregoing warranties and representations,
including without limitation, any claim or demand from any third party alleging
Presenter’s breach of any of the foregoing warranties and representations.

Presenter hereby grants NC AWWA-WEA a perpetual, non-exclusive license to copy,
distribute, record, make videos, DVDs, CDs, publish, reproduce the Work, to post the
Work on its website, to sell the Work or any copy or derivative thereof, to market and
publicize the Work, and to use Presenter’s picture, name and other information to
market and promote the Work and the Conference, all without any fee or compensation
paid or to be paid to Presenter by NC AWWA-WEA; provided that Presenter is
acknowledged by NC AWWA-WEA as the author and creator or the Work.

Presenter makes this Agreement and representations in consideration of NC AWWA-
WEA’s willingness to permit Presenter to appear and present the Work at the
Conference hosted by NC AWWA-WEA, and for other good and valuable consideration,
the receipt and sufficiency of which is hereby acknowledged.

This Acknowledgment is required to be made and the original of which returned to NC
AWWA-WEA before Presenter will be permitted to appear and present the Work at an
NC AWWA-WEA event.

_____________________________                              Date: ___________________________

Return the ORIGINAL of this Acknowledgment by _______________
To: ______________________________________________________


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