Consent. I understand that by submitting this form, I hereby grant permission to Nerve Communications to non-substantively edit (in accordance with print publication standards), reproduce, publish, and distribute the image(s) I created/took, in the book currently titled Coffee Table Science Vol 1, and in any future editions or derivative works of the book or marketing campaigns, in print and digital formats.*

Confirm. I confirm that I am the creator and copyright holder of the image(s) (or otherwise authorized to grant this permission), and that this consent is given without further claim to compensation. This permission is non-exclusive, royalty-free, and worldwide. I retain all copyright ownership of the image(s).*

Revoke. I understand I can revoke permission up until 40 days before publication with written documentation sent to Coffee Table Science via email, provided that such date is not 40 days before publication. After such time permission is irrevocable. Publication is defined by the date at which the book becomes available for purchase by online retailers.*

Release. I hereby release and discharge Coffee Table Science, its volunteers, employees, agents, and representatives from any and all claims, demands, or causes of action that I may have now or in the future arising out of or relating to the use of the image(s) I created/took, other than such rights expressly maintained under copyright ownership.*

Co-authors. If co-authors were added to this submission, I confirm all co-authors are aware of and approve this submission, including the image uploaded and authorship order. -OR- I did not add co-authors to this image submission, and I confirm no additional authors should be included in this submission.

Acknowledge. I acknowledge that I have read the above consent and release boxes in their entirety, or they have been read or translated to me, and I have had the opportunity to ask questions, seek advice, and confirm that I understand it.*