PAWA Membership Form

PAWA Membership Form

Please fill out the following two forms and mail with your check to:

Karla Koths – PAWA Membership

3085 NW Parris Rd

Poulsbo, WA 98370

Full Name *

First Name Last Name

Address *

Street Address

Street Address Line 2

City State

Postal / Zip Code Country

Phone Number *

Area Code Phone Number

E-Mail *

Website

Membership Options:

Associate Member: (Includes all paint-outs, discounts on PAWA sponsored workshops and shows) $30 per year

Advertising Member: (Includes all Associate Member benefits, plus a personal gallery page on the PAWA website) $60 per year

Are you willing to have your contact information made available to other PAWA members?

Yes

No

Are you a:

New Member?

Returning Member?

Volunteer Opportunities:

Paint-out Greeter – Greet artists as they arrive at paint-outs and provide local

resources information

Event Helper – Set up or clean up for meetings / events

Board Member – The Board meets monthly by Skype conference call

Promotion – Prepare or procure promotion for our events

Plein Air Washington Artist’s Release Form

Acknowledgement, Release and Assumption of Risk

I understand that Plein Air Washington Artists (PAWA) does not provide security for personal property and valuables during activities or in the lodging available to participants. I assume full responsibility for myself and my guests for any loss of personal property and valuables. I release and hold harmless from any claims concerning personal property or valuables PAWA and its officers and directors and the owners of any property on which PAWA Paint-Outs/Ins are held.

I assume full responsibility for myself and my guests for any injury during any PAWA activities. I release and hold harmless from any claims concerning personal injury PAWA officers, directors and the owners of any property on which PAWA Paint -Outs/Ins are held.

If I damage, mar or destroy any property owned by PAWA, or the owners of any property on which PAWA Paint -Outs/Ins are held, I agree to pay for all repairs or replacement of said property.

I agree that that photographs or videos taken during said activities may be used by PAWA for promotional purposes.

In the event that I am unable to authorize emergency medical transportation, I give PAWA and the owners of the property on which PAWA Paint -Outs/Ins are held, permission to request emergency services.

Name______Date______

Signature______

Emergency Contact Information:

Name______Relationship______

Phone Number______Cell Phone______