Revolutionizing Fiber and Needle Arts in the African Diaspora P.O. Box 111, New York, NY 10037-0111 Website: http://harlemneedlearts.org Email: harlemneedlearts@verizon.net Telephone: 212-491-8581 The Blossom of Fiber Art St. Nicholas Park – Harlem, New York June 28 and 29, 2014 Artist Registration Click on fields or tab key to enter your information. Upon completing the form, save and email back to HNA as an attachment. Thank you. Registration Deadline: MAY 9, 2014 at 11:59PM Last Name: First Name: Address: City: Best contact telephone#: State: Zip: Email: Total # of TERRACATA POT arrangements: Total # of CHAIR arrangements : Exhibition Agreement Terms and Conditions This is an agreement between: Harlem Needle Arts, Inc. (HNA) and Artist. The Artist agrees to loan the art work(s), each valued at no more than $300, outlined on the arrangement detail form to Harlem Needle Arts for the Blossom of Fiber Art exhibit held at St. Nicholas Park 134 Street to 136 Street and St. Nicholas Ave. LOAN PERIOD Loaned objects shall remain in the possession of the HNA from June 27 to June 29, 2014. Work will be returned only to the lender or his or her duly authorized agent or representative. The Artist is responsible for delivering art work in excellent and secure condition completely ready for display to the location designated by HNA. INSURANCE Harlem Needle Arts, Inc. will handle your work with care and insure work for no more than $300. Artist agrees to deliver and pick up artwork as instructed in Harlem Needle Arts, Inc. agreement. All art work(s) shall be of the structural integrity to be displayed for the duration of the exhibition. Artist agrees to give Harlem Needle Arts, Inc. permission to act as the offsite agent in the event of the sale of artist’s art work at a commission rate of 20%. All participating artwork will be photographed and presented before judges’ panel. Harlem Needle Arts has permission to utilize the photo images of the artwork on its website, marketing and promotional materials. The art work(s) described on the artist registration are hereby consigned by the artist for exhibition in The Blossom of Fiber Art and are warranted by the artist to be his/her own original creation and/or his/her unencumbered property. Harlem Needle Arts, Inc. will not assume responsibility for work left unclaimed after the de-installation of the exhibit. Artist Name: Print Harlem Needle Arts, Inc. Rep: Michelle Bishop Signature: Signature: Date: Date: June 27, 2014