I,(please print)________________________________am picking up _________ panel(s) of the AIDS Memorial Quilt for display purposes, and l agree to the following:
1) I am responsible and liable for the Quilt from the time they are given to me, until the time that I return them to the NAMES Project, NY Capital Region Chapter. I will follow predetermined arrangements made between the NAMES Project staff and myself for receiving and returning the Quilt.
2) While being displayed, the Quilt will be secured in a room that is non-smoking and does not allow for food or drink
3) During non-display hours through out the display, the Quilt must be in a locked room with limited access, and security will be provided when possible.
4) When being stored, the Quilt will remain in a locked room with limited access. They will remain in their storage bag or box.
5) The Quilt will not remain in any vehicle except when being transported, and I will not leave the Quilt unattended, in any car or other vehicle, even if they are in their bags or boxes.
6) No signatures or any other type of alterations will be permitted to any Quilt. I understand that I am required to supply proper security measures to make sure the Quilt is not altered in any way.
7) I agree that the Quilt will not be used as a backdrop for, or in support of, any political action except HIV/AIDS education and awareness.
I will return the Quilt panels to the NAMES Project Chapter on:____________
Signature of Person Accepting the Quilt:________________________
Date:___________
(make a copy of this form for your records)