BAYLISS PUBLIC LIBRARY EXHIBIT RELEASE

I, the undersigned, hereby lend the following works of art or other materials to the Bayliss Public Library for exhibit purposes only. In consideration of the privilege of exhibiting them in the Library, I hereby release said Library from responsibility for loss, damage, or destruction while they are in the possession of the Library.

Exhibition to be held in____________________________________________________

During_________________________________________________________________

Description of Materials Loaned_____________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________

Signature_____________________________________________

Address______________________________________________

Telephone_______________________            Date_____________

E-mail__________________________