Culture Fest Country Tables Agreement

Table Coordinator

Name:(Required)

First Last

Email:(Required)

Phone:(Required)

Additional Table Volunteers (if applicable):

Volunteer 1 Name:

First Last

Volunteer 1 Email:

Volunteer 1 Phone:

Volunteer 2 Name:

First Last

Volunteer 2 Email:

Volunteer 2 Phone:

Volunteer 3 Name:

First Last

Volunteer 3 Email:

Volunteer 3 Phone:

Indicate Items and Quantity Needed at Your Table (tablecloth is provided):

Electrical Outlet?(Required)

Yes

Easel?(Required)

Yes

# of Tables?(Required)

# of Chairs?(Required)

Items You Plan to Have at Your Table (check all that apply):

Paintings

Textiles

Pottery

Music

A Digital Presentation

Other

If 'Other', Please Specify:

Promotion and Publicity: I, the undersigned Table Coordinator, agree to give permission to Mesa County Libraries (MCL) to use, copy, modify, adapt, distribute, and/or publish my image, voice, and/or name obtained by MCL during Culture Fest for the purposes of promotion, advertising, publicity, and inclusion in MCL’s permanent collection of public library materials. This authorization and consent extends to websites, television, social media, print materials, digital media, and all other forms of media and communication, including MCL’s digital content library. I agree that MCL will own all rights to copy, modify, adapt, distribute, and/or publish materials in any media containing my image, voice, and/or name, and I will have no rights in the same. MCL considers the Table Coordinator’s signature to be consent for the group, including the table volunteers listed on this confirmation form.

Signature of Agreement (your typed name is your signature):(Required)

Date Signed:(Required)

Please note: after you click the 'Submit' button below, look for a confirmation message at the bottom of the screen. If you do not see that confirmation message, and if you don't receive an email copy of your submission, that indicates your submission did not go through. Please check the screen for form field errors.

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Culture Fest Country Tables Agreement