I warrant that this poem is entirely my own work, and that the underlying ideas, concepts, and make-up of the poem have not been taken from any other source or any other poem, but rather originate with this poem. I further attest that no one except me, the author and party to this binding agreement, has any title, claim, or proprietary interest in the poem.
I hereby indemnify the publisher against any action that can be taken against the poem, warranted or unwarranted, including libel, defamation, or infringement on any trademark, copyright, or patent, irrespective of any intention, state of mind, or aesthetic philosophy. I further attest that this poem has not been previously published, in part or in whole, in any print or electronic form, or in translation, or performed as part of a reading, musical, review, lecture, or show.
I grant the publisher worldwide rights to the poem, including serial, periodical, newspaper, magazine, book, bookazine, poster, indoor and outdoor display rights; and also digital, paradigital, and postdigital rights, as well as the rights to use the poem in secondary publications and markets, including franchise and commercial applications.
The poem will be copyrighted in the name of the publisher, and the author forthwith, without prejudice or duress, and with full consent, agreement, acquiescence, and concurrence, relinquishes rights to republish the poem in any form, print or electronic, or perform the poem at any fair, show, reading, lecture, musical, or review, without permission, notarized and in writing, from the publisher.
I agree to furnish the publisher, at my own expense and expeditiously, an electronic copy of the poem, as well as one hard copy or printout. I agree to review proofs of the poem and return them, at my own expense, within 36 hours of their receipt. The proofs will be delivered any time from later today until 3 January 2010.
In exchange for granting the publisher the aforesaid rights, I will receive, as payment in full, and as full recompense against any claims, levees, fees, honoraria, emoluments, endorsements, rights, permissions, or royalties, domestic or global, printed or electronic, digital, paradigital, and postdigital, the opportunity to subscribe to the publication in which the poem will first appear at forty percent discount from the full subscription price. To exercise this option, I agree to make payment in full in the next thirty (30) days.