33rd Annual Adam Styka Art Exhibit and Sale

Hosted by
The Polish Heritage Society of Philadelphia in cooperation with
The American Council for Polish Culture and
The National Shrine of Our Lady of Czestochowa

INSURANCE RELEASE

I agree that I will be solely responsible for the insurance coverage on the art work that I submit for the 33rd Annual Adam Styka Art Exhibit and Sale, which will take place at the National Shrine of Our Lady of Czestochowa, Doylestown, PA, opening on August 24, and on display Aug. 30, 31, Sept. 1 (Labor Day) and Sept. 6, 7, 2008.

I also agree that I will not hold the Polish Heritage Society of Philadelphia, the American Council for Polish Culture (ACPC) or the National Shrine of Our Lady of Czestochowa responsible for any damages incurred on my art work during the Exhibition.

Furthermore, I agree that insurance coverage on my art work to-and-from the Exhibition will be my responsibility.

Please return the signed insurance release, along with your application, to:

Marie Hejnosz
33rd Annual Adam Styka Art Exhibit and Sale
645 Renz Street
Philadelphia, PA 19128
tel: (215) 487-0221 or (215) 615-1558
Agreed and Accepted by:



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The Polish Heritage Society of Philadelphia
is an affiliate of The American Council for Polish Culture (ACPC)
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