LIBERTY DAY 2010, CEDAR BLUFF, AL

                                                          FOOD/RIDE VENDOR APPLICATION

 

Name__________________________________________DBA___________________________

 

Street Address__________________________________

 

City, State, Zip Code__________________________________  Email_____________________

 

Telephone-Home___________________Work___________________Cell__________________

 

We—DO _____  DO NOT _____  carry liability insurance for this event.

 

BOOTHS are approximately 10 x 12 –Number required________

 

ELECTRICAL REQUIREMENTS       How many outlets?______ Amps?______

Vender to furnish all extension cords—All equipment must be in good working order and subject to inspection.

 

VENDER AGREES to pay LIBERTY DAY an amount equal to 20% of total earnings taken in that day. This amount shall be payable at the close of the vendors’ concession at the end of days’ event. Checks to be made payable to Town of Cedar Bluff, LIBERTY DAY

 

List and describe the products to be sold in your booth. Include additional sheets if needed. All food items MUST be listed for Health Department approval. **Health Dept exempts one-day special events from inspection but requires information on all food products)

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HOLD HARMLESS AND INDEMNIFICATION AGREEMENT

We, the undersigned, for and in consideration of permission and space to participate in the Liberty Day Festival at Cedar Bluff, Alabama, agree to indemnify, hold harmless and defend the town of Cedar Bluff, AL, and the Cedar Bluff Parks and Recreation Committee its officials, representatives, agents, servants, volunteers, from and against any and all claims, action, lawsuits, damages, judgments, liability and expense, including attorney fees and litigation expense, in whole or in part arising out of, connected with or in any way associated with my/our activities preparing for Liberty Day or departing from Liberty Day. I have read and fully understand the above Hold Harmless and Indemnification Agreement.

 

Signature of Vendor_________________________________________________Date________________________

 

Print Name____________________________________________________________________________________

 

Signature of Parent/Legal Guardian (if under 19 years of age)____________________________________________

 

Printed Name of Parent/Guardian__________________________________________________________________

 

MAKE CHECKS PAYABLE TO

LIBERTY DAY

C/O Town of Cedar Bluff

P.O. Box 67

Cedar Bluff, AL 35959

 

For Additional information or questions contact: Town of Cedar Bluff at 256-779-6121 or email cblibertyday10@yahoo.com

 

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OFFICE USE ONLY—DATE REC’D_________________________       AMOUNT REC’D_____________________________