Shearonink, please just get Mrs. M. to send a copy of the exact text below; the only thing needed is to add her name and the date at the end.
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Send this to: permissions-commons@wikimedia.org
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Ref. OTRS #2010082910004702 http://commons.wikimedia.org/wiki/File:DeFord_Bailey.JPG
I hereby assert that I am the creator and/or sole owner of the exclusive copyright of the photograph uploaded to http://commons.wikimedia.org/wiki/File:DeFord_Bailey.JPG.
Permission is granted to copy, distribute and/or modify this document under the terms of the Creative Commons Attribution Share-Alike License 3.0, and the GNU Free Documentation License, Version 1.2 or any later version published by the Free Software Foundation; with no Invariant Sections, no Front-Cover Texts, and no Back-Cover Texts. A copy of these licenses are held at http://commons.wikimedia.org/wiki/Commons:Creative_Commons_Attribution-ShareAlike_3.0_Unported_License and http://commons.wikimedia.org/wiki/Commons:GNU_Free_Documentation_License.
I acknowledge that I grant anyone the right to use the work in a commercial product and to modify it according to their needs, provided that they abide by the terms of the license and any other applicable laws.
I am aware that I always retain copyright of my work, and retain the right to be attributed in accordance with the license chosen. Modifications others make to the work will not be attributed to me.
I acknowledge that I cannot withdraw this agreement, and that the content may or may not be kept permanently on a Wikimedia project.
FILL IN HERE: DATE, NAME OF THE COPYRIGHT HOLDER