Please PRINT your name clearly ____________________

Insurance Waiver and Assumption of Loss

*ONLY ONE NEEDED PER MEMBER*

Your entries may already be protected by your homeowner's policy. The insurance policy that covers Oregon Coastal Quilters Guild is a personal injury liability policy only. It does not provide any protection against property damage, loss or theft. We will handle the entries with great care and our hostesses will watch guests to prevent the public from handling them as much as possible. Therefore, we ask all entrants to sign the following statement to evidence their recognition and assumption of risk and return this form to the Depot when you drop off your quilts. One waiver will cover all your entries. You do not need a separate "waiver" for each entry.

LABEL Tack to LOWER RIGHT CORNER of back of quilt or inside the garment. Please fold quilt/item so this label shows. NAME:_________________________________ PHONE:________________________________ QUILT NAME:___________________________ QUILT SIZE (sum of all sides):______________ GARMENT TYPE:__________________________ ENTRY # ______________________________ By signing this statement, I expressly agree to release Oregon Coastal Quilters Guild of Lincoln County, Oregon and their respective agents, employees, and members from all liability for any loss, damage, theft, injury, or destruction to any article entered by me in the guild's Quilt Show. I under stand and assume that I bear the risk of all uninsured loss to my own property and this is up to me to properly insure against any and all risks if I so choose.

My I/O Station is:	If I am not able will pick up my entries.

Signature	Date:

Please list all items entered or displayed at the quilt show and/or check the box labeled Boutique if you had items for sale.

Write on the back of this sheet if you require more lines.

Item description* and Title	Registration Number	Entry Number**	Picked Up

*Simple description i.e. Quilt, Bag, Jacket, Pillow, etc.	Boutique

**Entry Number filled in by I/O Clerk at Intake on Monday before the show

Items returned to: ______________________________ ___________________________________ _________

Print Name	Signature	Date