Visual Arts Department Student Exhibition Waiver
Artist’s Name: ________________________________________________
PID:
_______________________________________________________
Other Group Members (if any): ___________________________________
Major & Class Standing: ________________________________________
Course name & number: _________________________________________
Instructor: ____________________________________________________
Project Title: __________________________________________________
Project Description : ____________________________________________
Medium: _____________________________________________________
Address: _____________________________________________________
Telephone #: __________________________________________________
Email Address: ________________________________________________
I, the undersigned, have voluntarily decided to participate in the Visual Arts Department Student Exhibition. I
agree to allow the Visual Arts Department to display my artwork in the main undergraduate office or the
Mandeville Seminar Room for a length of one quarter as part of the Student Exhibition. I agree to work and
communicate with, and allow the release of my contact information to the student curator(s).
I understand that I will be responsible for picking up my artwork at the end of the quarter in which it is displayed.
The Visual Arts Department may dispose of my work by finals week one quarter following the display of my
artwork in the Exhibition if I fail to pick up my work from the department office.
I understand that my artwork may be lost, stolen or damaged during the Exhibition and that the artwork displayed
in the Exhibition is not insured by UCSD.
Waiver of Liability, Assumption of Risk, and Indemnity Agreement
In consideration of being permitted to participate in the Exhibition, I, for myself, my heirs, personal representatives
or assigns, do hereby release, waive, discharge, and covenant not to sue The Regents of the University of
California, its officers, employees, and agents from liability from any and all claims including the negligence of
The Regents of the University of California, its officers, employees, and agents, resulting in property loss or
damage arising from my participation in the Exhibition.
I understand that this is a voluntary student exhibition for which I will not be monetarily compensated.
I acknowledge that the Exhibition is part of the UCSD Visual Arts Department. Inclusion of my artwork in this
Exhibition is granted at the sole discretion of the Visual Arts Department and may be revoked at any time.
___________________________________________
Student Signature
Picked artwork up: ________________
_________________
Date
Initials: _________
11/15/04