North Liberty Library Mural Project Application

U.A.Y. is looking for 5 enthusiastic and dedicated youth artists from North Liberty to collaborate with a local BIPOC artist on a large-scale mural located at the North Liberty Public Library. All artists who apply should be in grades 7th-12th. The mural design is currently pending and will be a collaboration between the lead artist and the Mural Team.

If you are interested, please fill out the following application.

Once you have filled out the application, Lauren Linahon will reach out to you to set-up an informal interview.

If you have any questions, please contact Lauren Linahon at Lauren.Linahon@unitedactionforyouth.org

Thank you!

Youth Artist Information*

First NameLast Name

Pronouns

Youth Artist's Address

City

State

Zip

Cell Phone*

If you don't have a cell phone, put "NA"

Email*

example@example.com

Date of Birth*

Date

School*

Allergies

Best way to contact you

EmailTextPhone Call

Parent/Guardian Name*

First NameLast Name

Parent/Guardian Address

City

State

Zip

Cell Phone

Email*

example@example.com

Best way to contact you

EmailTextPhone Call

Parental/Guardian Consent for Participation

I give permission for my youth/child, to participate in the United Action for Youth/ North Liberty Library Mural Project. In the event that my youth/child should receive injury while participating in this program, I waive and release each and every member of the UAY Board of Directors, staff and volunteers from any claim or liability as a result of any injury that might be sustained by my youth/child.

Parent/Guardian Signature*

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Parent/Guardian Name*

Parental/Guardian & Youth Participant Consent for Media Release

I hereby grant permission to United Action for Youth and the North Liberty Library the right to use, reproduce, and/or distribute photographs, films, video-clips, and sound recordings of my youth/child and/or my youth/child's art work, without compensation or approval rights, for use in materials created for purposes of promoting the activities of the United Action for Youth.

Parent/Guardian Signature*

Clear

Parent/Guardian Name *

Youth Participant Signature*

Clear

Youth Participant Name*