LIBERTY DAY 2012, CEDAR BLUFF, AL

ANTIQUES, ARTS & CRAFTS 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.

 

Number of Spaces desired @ $65.00 each                      $______________________________

Electricity @ $15.00 addition per space                           $______________________________

Total (include TOTAL amount please)                           $______________________________

 

BOOTHS are approximately 10 x 12 –Number required________

 

ELECTRICAL REQUIREMENTS       How many outlets? ______  Amps? ______

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

 

List and describe the products to be sold in your booth. Include additional sheets if needed.

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

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 38

Cedar Bluff, AL 35959

 

For Additional information or questions contact: Town of Cedar Bluff at 256-779-6121 or email cblibertyday@tds.net

 

_______________________________________________________________

 

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