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Old Fashion of July Festival Vendor Application July 4, 2021 Please complete all information and sign as indicated. Incomplete forms will be returned. Business/Organization Contact Name Mailing Address City State Zip Telephone E-mail Make/Model Vehicle if needed: License Plate # Trailer Size: LIMITED NUMBER OF 10’X 10’ SPACES AVAILABLE all for $25.00. *One booth per Non—Profit Organization FOR FREE. *Non_profits must show proof of non—profit status BY 503C OR STATE REGISTRATION AS A NONPROFIT. TOTAL AMOUNT DUE Please indicate if you would like separate or adjoining locations if requesting more than 1 booth space. All applications are reviewed for quality and duplication. We ask you to tell usfor what type of items to be sold at your booth: Please read, sign and return original Application, Payment, and Proof of Liability Insurance to: Town of Pahrump 2100 E. Walt Williams Suite 100 Contact: 775—727—51074 Fax: 775— Email: @pahruinpnv. org THE DEADLINE FOR APPLICATIONS ARE APRIL 15, 2021 FOR NON-PROFITS, MAY 15, 2021 FOR CRAFT BOOTHS AND FOOD TRUCKS AND FOOD VENDERS DATE IS JUNE 15TH. ---PAGE BREAK--- APPLICATIONS DO NOT GUARANTEE BOOTH UNTIL FEES ARE PAID IN FULL AND PROOF OF LIABILITY INSURANCE NANING THE TOWN OF PAHRUNP AS ADDITIONAL INSURED ARE RECEIVED. representing. , have read the Booth Policies, Procedures and Requirements for application to participate in the 2021 July of July Fall Festival. I fully understand the Policies, Procedures and Requirements, of which I have a copy and will comply with them. Failure to comply could result in a suspension of my/our rights to set up a Booth at this or any future events. Signature — Date. PLEASE NOTE ASSIGNED VENDOR SPOTS ARE FINAL. NO CHANGES WILL BE MADE DURING THE EVENT. ---PAGE BREAK--- Old Fashion 4th of July Pahrump Festival Vendor Application Liability Signatures Business/Organization Contact HOLD HARMLESS: Vendor shall be solely responsible for any and all injuries to persons or damages to property or any other injury, claim damage or loss of whatever nature, arising from or related to the 4th of July festival. Vendors shall indemnify, save and hold harmless the Town of Pahruxnp, its Board, staff, officers, agents and employees from and against all liability, loss, damages, claims, costs and expenses (including reasonable attorney’s fees) arising out of injury to person (including death) or damage to property or any other injury, claim, damage, loss, cost or expense arising from the of July Festival performed by vendor, including but not limited to, any negligence, act or omission of vendor. Signature Date LIABILITY: The festival will provide minimal security for the one day event; however, participants are responsible for their own merchandise and equipment, its protection and insurance. The Town of Pahrump, its Board and its staff will not be responsible for losses of any kind, whether by fire, theft, physical violence, elements of nature or any other cause, however originating. Participants are responsible for their own merchandize and equipment, its protection and insurance. Signature Date ---PAGE BREAK--- Old Fashion 4th of July Pahrump Festival Vendor Application Electrical Service Information Sheet Business/Organization Contact • List all electrical equipment to be used during this year’s 4th of July Pahrump Festival. • Voice amplification equipment, such as bullhorns and loudspeakers are not permitted. *Due to the limited power availability at the Festival grounds, we can supply you with only 110 Volts,15-amp breakers. The power source will be within 50’ of your booth. You will have to supply enough cord to reach that point. WE CAN SUPPLY YOU WITH ONLY 1 OUTLET OF 110 VOLTS. FIRST COME FIRST SERVED Signature of Applicant Date TRAILERS: Number of Trailers Length of Trailer (include tongue) Width of Trailer ---PAGE BREAK--- FOR OFFICE USE ONLY: Received: Method of Payment: Amount: