WSVNRadio.net
P.O. Box 132
Thornton, IL 60476-0132
WSVNRadio@yahoo.com

To: WSVNRadio

Re: WSVNRadio Compilation CD, Waiver

This is to inform the artist (______________), is eligible for a future WSVNRadio Hall of
Fame compilation CD. (enter name above)

This confirms that the artist/group have agreed to let WSVNRadio allow one song and appropriate
artwork/photo for a future compilation CD, The WSVNRadio Hall of Fame.

Please provide the appropriate information below, regarding the song you will be contributing, and
email (preferred) or send by regular mail this signed document to WSVNRadio. There is no money to be made for
this compilation; it is a Promotional Item ONLY.

Due to cost factors, an optional payment of $9.95 will be charged for the supplies and shipping for this compilation. Please indicate below, regarding your payment:

YES, I will pay for the CD copy for the cost of $9.95. Please indicate which payment below:

PayPal

Money Order
(An invoice will be billed to your email.)

NO, I will appear on this compilation, but do not wish a CD copy. Please send all 20 mp3s to my email account.

Thank you again, for letting WSVNRadio allow your time and music to be shared for this compilation.

Artist Name: _____________________	Email Address: _____________________
Album Title: _____________________	Year of Release: ________________________
Song Title: _____________________	Website: ________________________
Writer(s): _____________________	Postal Address to Send CD:
Producer: _____________________	___________________________________
Publisher: _____________________	___________________________________
Date: _____________________	___________________________________
Signature: _____________________