COPYRIGHT RELEASE FORM

FOR IMAGES, ARTWORK, and WRITTEN WORK

I, the undersigned, understand that by submitting my entry (images, artwork,

and written work) to the National Commission for Culture and the Arts (NCCA)
for the ASEAN-Philippines Digital Art Contest 2022, I hereby agree, certify,
and declare that:

1) The undersigned is the copyright owner/holder of the submitted entry

(images/artwork, and written work) or if applicable, is authorized to sign
on behalf of the copyright owner/holder through a notarized special
power of attorney or secretary’s certificate;

2) The undersigned is of legal age and legal capacity to sign this document;

3) The undersigned grants the NCCA the right to adapt, publish,

disseminate, or otherwise use the submitted entry (images/artwork, and
written work), in whole or in part and in whatever manner the NCCA may
deem appropriate, without further permission and compensation.
Provided, it is within the mandate of the NCCA, and the undersigned is
recognized as the author of the work; and

4) The undersigned hereby releases and discharges the NCCA, its officials,
and employees from any claims, damages, legal action, and/or otherwise
as may be due in connection to any violation of intellectual property rights
of the submitted entry (images/artwork, and written work).

Name of Author/Artist VEA AMOR G. LOPEZ

Name of the Artwork AMALGAMATE

VEA AMOR G. LOPEZ

Signature over printed name

AUGUST 11, 2022

Date