Name of Artist/Registrant:________________________________________

Name of Exhibition_____________________________________________

For myself, or in behalf of the above listed minor, for whom I am responsible as either parent or legal guardian, I state:

• I am 18 years old or older
• The registrant desires to participate in the above listed exhibition
• I give permission for the registrant to participate in the above listed exhibition
• I am aware that Unity Church of Lawrence does not insure or agree to be responsible for any theft, damage, or loss of any article. I freely choose to exhibit in the Unity Art Gallery, 900 Madeline Lane, Lawrence, Kansas. I agree to accept any and all loss, theft, or damage resulting directly or indirectly from registrant’s participation in these activities.
• In return for the benefits the registrant will receive from participation, I agree both not to sue or to hold the Unity Church of Lawrence, its directors, its officers, its employees, its agents, and its volunteers for and from liability and responsibility for any loss, theft, or damage connected with registrant’s participation in the exhibition.
• I understand that this release is intended to protect Unity Church of Lawrence, Unity Art Gallery, Unity Bookstore, its directors, its officers, its employees, its agents, and its volunteers from any claim of negligence (the failure of reasonable care.)
• I understand that this is a release from liability, a hold harmless agreement, and an assumption of risk agreement.
• I understand that this is a legally binding contract between the Unity Art Gallery and myself, and that it is binding on myself, my heirs, or anyone making a claim.
• I have carefully read this agreement and fully understand its content. I sign of my own free will.
• I give Unity permission to use photos taken in the gallery for promotional purposes for Unity Church, Unity Gallery, or Unity Bookstore.

Signature ________________________________________

Date _______________________________