Fountain Hills Community Center Art Exhibition Artist/ Owner/ Agent Agreement

I, ___________________ (Name)___________________________(Address) ______________(Phone) hereby confirm that I am the creating Artist, Owner, and/or authorized Agent for the works of art listed below which are being released for exhibit at the Fountain Hills Community Center. I understand and acknowledge that while the Management and staff of the Fountain Hills Community Center will extend reasonable efforts for the security and safe Keeping of these works, neither the Community Center, its staff nor the Town of Fountain Hills Accepts any responsibility for such safe keeping, and that it is my responsibility provide insurance coverage or other protection as I deem appropriate. Along with the Title and size of each piece listed, I am including a sale price for any items that are offered for sale. In the event that a sale is transacted, I understand that an Exhibit Charge in the amount of $35.00 will be due and payable to the Town of Fountain Hills. Title                                                                     Size                              Price _____________________________________ ________________      _______ _____________________________________ ________________      ________ _____________________________________ _________________    _________ _____________________________________ ________________      _________ Signed:_______________________________ Receipt Acknowledged___________ Date:_________________________________ by___________________________ Above articles returned to Owner/Agent_________(Date) by_______________________ Received by Signature and Date:_____________________________________________