2023 CLEAN DRAINS FORT WAYNE Application

This is the application to install a drain mural in Fort Wayne in 2023. A limited number of artists will be chosen to participate. Those selected will be given a artist stipend. Selected artists will be assigned to a speciifc mural site and be given specific dates of installation in the summer of 2023. Artists will be provided a bucket with all the supplies they need to install the mural (paint, brushes, tape, saftey vest, and instructions for installation).

Artist Name*

First NameLast Name

Artist Email*

example@example.com

Please indicate the neighborhood where you live, if applicable.

Example: Northside Neighborhood, Mount Vernon Park, Packard Park, etc.

Artist Phone Number*

Please enter a valid phone number.

Artist Mailing Address*

Street Address

Street Address Line 2

CityState

Postal / Zip Code

THIS PROJECT IS ABOUT EDUCATING OUR COMMUNITY. PLEASE INDICATE THE VERBIAGE YOU INTEND TO INCORPORATE INTO YOUR DRAIN MURAL DESIGN. YOU MUST CHOOSE THE PREPARED OPTION or SUBMIT YOUR UNIQUE PHRASE, WHICH WILL BE REVIEWED BY THE COMMITTEE. IF YOUR UNIQUE PHRASE IS NOT APPROVED BY F.O.R., ARTISTS MUST USE 'ONLY RAIN IN THE DRAIN.'*

ONLY RAIN IN THE DRAINOTHER: CREATE MY OWN UNIQUE PHRASE (type in your phrase below)

IF you indicated 'OTHER' above, please type in your drain art phrase here:

Please use proper grammar and indicate any punctuation you intend to include in your verbiage. This text may or may not be approved by F.O.R.

Upload Image of PREVIOUS WORK (PLEASE LABEL FILE WITH YOUR NAME) *

Please label file with your name_medium

Upload CLEAN DRAIN DESIGN IDEA (please use the template below)) *

Please label file with your name

DRAIN TEMPLATE

Please indicate which month(s) you'd prefer to install your mural in 2022. (Select all that apply).

LAST TWO (2) WEEKS IN JULY 2023LAST TWO (2) WEEKS IN AUGUST 2023

ELIGIBILITY*

Artist is responsible for arranging any desired insurance coverage for personal or liability purposes. Artist agrees to indemnify, defend and hold harmless the FOR, their employees and representatives from any and all claims or causes of action of any kind, and any and all costs and expenses, including attorney's fees, arising from the performance of this project. By checking this box, you acknowledge and agree you are participating in the 2023 Clean Drains Program (“Program”) on a voluntary basis and your participation may involve risks inherent to the activities being undertaken in connection with the Program. You acknowledge that you knowingly and willingly accept such risks and that the City of Fort Wayne and Friends of the Rivers shall have no liability related to your participation in the Program whatsoever. By checking this box, you agree to release, discharge, and hold harmless the City of Fort Wayne and Friends of the Rivers, and each of their respective employees, agents, and representatives, of and from all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating to your participation in the Program, whether as a result of bodily injury, property damage, or death. You further acknowledge that this release includes any claims, actions, damages, costs or expenses based on the actions, omissions, or negligence of the City of Fort Wayne and Friends of the Rivers, and each of their respective employees, agents, and representatives.Photo Release & Documentation Waiver: Artist agrees to permit FOR and its designated personnel to photograph, video and document The Clean Drain Fort Wayne project, and use resulting materials without restrictions or royalties paid to the Artist for archival, promotional, marketing, website, educational and such other purposes as the FOR shall determine. Such photographic and documentary materials shall be the property of FOR.Artist is 18 years old or older, or has permission from a parent/guardian to participate in this projectArtist can install their mural design in the summer of 2023