Montgomery College Single Parent Conference 2019
Exhibitor Registration
Empowered Parents Create Stronger Families
Saturday, August 10, 2019 • 8:30 a.m.– 2:00 p.m.
Montgomery College - Rockville Campus, Science Center Building
Please submit this form by April 12, 2019 to Taryn Billand at
taryn.billand@montgomerycountymd.gov
Exhibitor Name/Organization Name
Type of Organization
Contact Name
Additional Staff Attending (up to two (2) per program)
Street Address
Street Address Line 2
City/State Zip Code
Phone Number
Email Address
Exhibitor/Organization Website**
Name of Program*
Description of services being displayed, as well as the population served (max. 100 words)
Table Reservation
Tables (6 feet in length) and two (2) chairs will be provided. Table covers will not be provided, please feel free to
bring your own. One (1) additional chair may be requested, subject to space availability.
Electrical access needed (Limited availability - first come, first served basis. (Please bring own power cord.)
Additional chair needed
Displaying large vertical banner(s)
Participants will need access to computer work stations
Photo Release form has been completed***
Please save this form before attaching it to your email
Choose One
Important Event Information
•Exhibitor set up: 7:30 a.m. – 8:15 a.m.
•Exhibitors are responsible for set up and tear down of their materials from the tables.
Complimentary coffee and refreshments will be provided.
•Event: 8:30 a.m. to 2:00 p.m.
•Lunch will be provided for up to two (2) exhibit staff members.
•Parking is available in Lot 11, adjacent to the Science Center (SC) building.(See map attached to email).
*Multiple Programs within an organization should complete a separate form for each Program
**Exhibitor/Organizer web addresses will be added to the Single Parent Conference website.
***Please complete and sign attached Photo Release form
1
Photo Permission Agreement
I hereby give my permission and consent for Montgomery College and its successors and assign to use my likeness in a photograph
or photographs taken by a designated photographer, for any and all promotional purposes of Montgomery College, without
restriction as to frequency or duration of usage. I further understand, acknowledge and agree as follows:
1. I have the right not to consent to the release of said photograph(s), and my consent is voluntary.
2. Montgomery College shall have the full and exclusive right to display, edit, sell, publish and reproduce or cause to be reproduced
said photograph(s) in any medium, whether print, electronic or any other, to use the photograph(s) in any context and to use said
photograph(s) in catalogs, advertisements, billboards, films, or any other way in connection with the promotion of Montgomery
College.
3. Montgomery College and its successors and assigns shall have the full, exclusive and complete ownership of said photograph(s)
and their reproductions and other materials (and all rights therein, including the copyright) produced pursuant to this release,
which shall be deemed the sole property of Montgomery College, all of which ownership and other rights I hereby grant to
Montgomery College for good and sufficient consideration.
4. I hereby, in advance, release, waive, forever discharge, hold harmless and covenant not to sue Montgomery College, its
trustees, employees, students, contractors, agents or representatives from and against any and all liability for any harm, injury,
damage, claims, actions, causes of action, costs, demands, and expenses of any nature whatsoever relating to the use of sai
d
photograph(s) by Montgomery Coll
ege, to representations made or to the grant of rights to the photographs hereunder.
5. I understand that this written consent shall remain in effect until revoked by me in writing and delivered to the Director of Media
and Public Relations, Montgomery College, together with the lapse of a reasonable amount of time to remove said
photograph(s) from future publication; nevertheless such revocation shall have no effect whatsoever on publication of the
photograph(s) prior to the effective date of the revocation, nor shall the revocation affect any of the obligations contained herei
n
with respect to such use or disclosure of said photograph(s) by Montgom
ery College, and any consequences flowing therefrom.
6. This Agreement constitutes the entire agreement between the parties concerning the subject matter and shall by governed by
the laws of the State of Maryland (except conflict of laws provisions). Any modification of this Agreement shall be in writing and
signed by both parties. If the likeness is of a minor person, then a parent or legal guardian shall also sign the Parental Consent
Addendum attached to this Agreement and shall initial any modifications of this Agreement.*
7. I hereby warrant and represent that I am at least eighteen (18) years of age,* have the full right to contract in my own name with
respect to the matters stated above, and have no conflicting advertising or promotional commitments that would cause me to be
unable to enter into this Agreement or to grant the rights hereunder, which I hereby make binding on my heirs, next of kin, and
personal representatives.
AGREED AND ACCEPTED PARTICIPANT: MONTGOMERY COLLEGE
___________________________________ ___________________________________
Signature Signature
___________________________________ ___________________________________
Printed Name Printed Name
___________________________________ ___________________________________
Address Title or Position
___________________________________ ___________________________________
Date Date
___________________________________
e-mail Address
___________________________________
Name of Course (i.e. AC201 Accounting)
* Parent/guardian must complete the Parental Consent Addendum if the above-named individual is under eighteen (18) years of age:
2
MONTGOMERY COLLEGE
PARENTAL CONSENT ADDENDUM
TO
PHOTO PERMISSION AGREEMENT
I, the undersigned, warrant and represent that I am the parent or legal guardian of , whose signature
appears on the attached Photo Permission Agreement. I have read the Agreement and understand and am fully familiar with its
contents, and I hereby grant my permission and consent to all of its provisions and guarantee the Participant’s obligations under the
Agreement.
PARENT OR LEGAL GUARDIAN MONTGOMERY COLLEGE
___________________________________ ___________________________________
Signature Signature
___________________________________ ___________________________________
Printed Name Printed Name
___________________________________ ___________________________________
Phone Number Title or Position
___________________________________ ___________________________________
Address Date
___________________________________
Date