Healing with Art

Registration Form
Name: ____________________________________________________________________________________________

Father/Guardian’s Name: _____________________________________________________________________________

Date of Birth: ________/_________/__________ Age: _________________ Gender: __________________________

Company/Institution (If Any): ___________________________________________________________________________

Mailing Address: ____________________________________________________________________________________

__________________________________________________________________________________________________

Phone: _______________________Mobile: ______________________ E-mail: __________________________________

Artist Category:
Normal Special
If Special Category, please specify detail:
Special/Handicapped Artists Artists who are cirrhotic or have undergone Kidney or Liver transplant
Artists belonging to remote rural areas of Pakistan Please specify the area: _______________________

Art Category:
Paintings Calligraphies Sculptures Digital Arts Graphic Arts Printmaking Drawings
Other (If any): ____________________________________________________
Media:
Traditional Media Digital Media Others: _____________________________________

Other Technical Specifications (If Any):

_________________________________________________________________________________________________
_________________________________________________________________________________________________

Undertaking
I have accepted the terms and conditions of entry and pre-selection, which I have read, and I declare that this work of
art is entirely my own work and I hereby indemnify PKLI&RC.

Signature: __________________________________ Date: ______/______/__________

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TO BE FILLED BY PKLI&RC OFFICE ONLY:

Registration No: _______________ Date: ______/______/________ Signature: ________________________________

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 Healing with Art
Terms and Conditions

 There is no registration fee.

 The works of art must be the original work of artist.
 The submitted works of art will be considered as donation to PKLI&RC and those will be the
property of PKLI&RC.
 The works of art must not be contrary to our religious and cultural values.
 Maximum five (05) entries per artist/submitter are allowed.
 The work of art should be of standard size, properly framed and mountable to wall
 Registration form should be signed and submitted along with each work of art.
 Jury will comprise of highly qualified professionals from creative disciplines and PKLI&RC
management.
 Jury’s decision will be final.
 All the submitted works of art will be the property of PKLI&RC and no compensation will be
provided to artist/submitter.
 PKLI&RC holds the right to display, reproduce, mention, print, reprint, advertise or sell any of
the submitted piece of art anywhere, anytime to help ailing patients and PKLI&RC will not
take any prior approval or intimate the artist for these activities.
 Artists will not be paid any royalty or compensation.
 PKLI&RC reserve all rights to postpone or cancel the competition without prior notice.
 Last date for submission of works of art is 12th December 2017.

Works of art along-with registration forms may be sent/submitted to the following address:
Marketing Department
Pakistan Kidney and Liver Institute and Research Center
4th Floor, Salaar Center
13 – Babar Block, New Garden Town, Lahore, Pakistan
Phone: 042 – 38107554 │ Email: marketing@pkli.org.pk

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