`

WAIVER AND ASSIGNMENT OF COPYRIGHT

We ,
, ,

, ,
,

,
, , Filipinos of legal age, and with address at
Philippines, after being sworn to in accordance with law, depose and state that.

1. We belong to the group _, and we composed the

song entitled _;
2. The mentioned song is our original composition and was not copied from
anyone.
3. The mentioned song is the piece that we entered in the contest entitled
“Calumpiteno ang Boses ng Pagbabago” organized by Ms. Glorime "Lem "
Faustino;
4. As a participant in the contest, we hereby assign and transfer to the organizer of
the said contest my whole rights and interest over the aforementioned song and
the same to be held by them as the same would have been held by me had this
assignment not been made;
5. We waive any claims, criminal or civil, copyright, economic or moral right,
against the organizer over the aforementioned composition and forever release the
latter from any and all liability.

IN WITNESS WHEREOF, we have hereunto set my hand this day of

2021 at _, Philippines.

Affiant/Participant 1 Affiant/Participant 2

Affiant/Participant 3 Affiant/Participant 4

Affiant/Participant 5 Affiant/Participant 6

Affiant/Participant 7 Affiant/Participant 8

Affiant/Participant 9 Affiant/Participant 10
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SUBCRIBED AND SWORN TO BEFORE ME this day of 2021 at

Philippines affiant personally appears before me presenting his as
proof of his identity.

Doc No:
Page No:
Book No:
Series of 2021