LIBERTY DAY 2012, 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 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. Make
checks payable to the Town of Cedar Bluff.
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 Department
exempts one-day special events from inspection but requires information on all
food products being sold.
_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
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
For Additional information or questions contact: Town
of Cedar Bluff at 256-779-6121 or email cblibertyday@tds.net
Please note
that your signature on this application does not guarantee you a spot in
Liberty Day. You will be notified if you are selected.
_________________________________________________________________
OFFICE USE ONLY—DATE REC’D_________________________ AMOUNT
REC’D_____________________________