ANNUAL SWEDISH MS CENTER ART SHOW

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1 ANNUAL SWEDISH MS CENTER ART SHOW 2018 Art Show Application Form To participate in the Annual Swedish MS Center Art Show, submit this application form and your artwork/s by 4:00 p.m. on Friday, May 25, Your application form and artwork(s) can be delivered separately, but all materials must be received by the deadline. Application can be submitted anytime, artwork can be delivered to the MS Center starting Tuesday, May 1. Personal Information Name: Street Address: Apartment/Unit #: City: State: Zip Code: Phone Number: Address: Would you like to receive s from the Swedish MS Center? (Check all that apply): Monthly Newsletter (news and event info) Art Show (event info and reminders) MS Roadshows (event info and registration) Adventure Program (special event info) Other (please specify): What is your connection to MS? (Please check all that apply): I have MS (Year diagnosed: ) I know someone with MS: Spouse Family Friend Colleague I am a Caregiver to someone with MS Other (please explain): Are you interested in volunteering at the Art Show? Yes No Dates: June 23, 2018 June 24, 2018 Times: AM PM to AM PM

2 Swedish MS Center Annual Art Show Application Form, Page 2 of 7 Artwork Information: 1st priority display* *If the number of artworks received exceeds the display capacity, only your piece marked 1st priority may be displayed. Title: Medium (painting, photo, sculpture, etc.): Dimensions (inches and pounds): 2D: inches x inches 3D: inches x inches x inches Weight: lbs. File name of artwork image (.jpg or.gif file if submitting electronically): Is this item for sale? Artist statement - OPTIONAL (limit 200 words or eight sentences; you may attach additional pages): Yes No Amount (if applicable): $

3 Artwork Information: 2nd priority display Title: Medium (painting, photo, sculpture, etc.): Swedish MS Center Annual Art Show Application Form, Page 3 of 7 Dimensions (inches and pounds): 2D: inches x inches 3D: inches x inches x inches Weight: lbs. File name of artwork image (.jpg or.gif file if submitting electronically): Is this item for sale? Artist statement - OPTIONAL (limit 200 words or eight sentences; you may attach additional pages): Yes No Amount (if applicable): $

4 Artwork Information: 3rd priority display Title: Medium (painting, photo, sculpture, etc.): Swedish MS Center Annual Art Show Application Form, Page 4 of 7 Dimensions (inches and pounds): 2D: inches x inches 3D: inches x inches x inches Weight: lbs. File name of artwork image (.jpg or.gif file if submitting electronically): Is this item for sale? Artist statement - OPTIONAL (limit 200 words or eight sentences; you may attach additional pages): Yes No Amount (if applicable): $

5 Artist Biographical Information - OPTIONAL Swedish MS Center Annual Art Show Application Form, Page 5 of 7 The Artist Biography is optional. Your response, and a picture if you choose to submit one, will be featured in our 2018 Artist Catalogue. If submitting your application form by , images should be.jpg files. Please put the artist s first and last name in the subject line. Please tell us about yourself as an individual and an artist. This could include your connection to MS, your age, where you live, your hobbies, what inspires you, your goals, and more. Please limit your response to 250 words (about 10 sentences). You may attach additional pages. Are you including a picture of yourself? Yes No

6 Swedish MS Center Annual Art Show Application Form, Page 6 of 7 Annual Swedish Multiple Sclerosis Center Art Show 2018 Waiver and Release Form I,, will be displaying my art for the Swedish MS Center Art Show to be held at the Seattle Center Armory on Saturday and Sunday, June 24 and 24, My art is described as I understand, acknowledge and agree to the following: My art is ready to be hung or placed and is appropriately framed (if applicable) and includes all needed hooks, wires and /or pedestals. Swedish Medical Center and the MS Center will not be liable to me or my agents for any harm or injuries suffered by me or my agents relating to placement and/or take-down of my art. Swedish will NOT be liable to me or my agents for any harm or injuries suffered by me or my agents relating to Swedish MS Center Art Show. Swedish and the MS Center do NOT provide insurance for the loss, damage or theft of my art while it is being displayed at the Show and will NOT be held liable for any loss, damage, or theft caused during the Show or during transit to and from the Show and while the art is stored at Swedish MS Center. Swedish Medical Center, Swedish MS Center, Seattle Center and their employees are not responsible for any items left on the premises after the event, be they personal property or rental materials. I hereby release, discharge and agree to hold harmless Swedish, the MS Center, its employees, agents and individuals involved in creating the Art Show from and against all liability as a result of any harm, damage and/or loss of my art. I agree to defend, indemnify and hold harmless Swedish, the MS Center, its employees, agents and individuals involved in creating the Art Show from any claims by third parties alleging that my art infringes on any third party s rights. I have read this waiver and release and by signing below, I warrant that I fully understand the contents of this waiver and release. Artist/guardian signature Date Artist or guardian/representative name (printed)

7 Swedish MS Center Annual Art Show Application Form, Page 7 of 7 Consent for Use of Image I previously consented to having my artwork displayed at a Swedish Health Services ( Swedish ) facility and/or event. By signing below, I consent to Swedish for the use of my artwork s image to be displayed and/or printed in a Swedish-sponsored publication. I understand that my name will be attributed as artist of the artwork. I understand that my participation is voluntary. I have the following restrictions regarding Swedish s use of my artwork s image: (If no restrictions, write none. ) Name Date Signature Witness Date

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