VENDOR NUMBER:
FOR OFFICIAL USE ONLY
2018 Mutt Strut Vendor Application
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For Profit Non-Profit
Event Date: Saturday, February 10, 2018 Vendor Set-Up starts at 9:30 AM Event is from 12-4 P.M.
Business Name:__________________________________________________________________ Your Name:_____________________________________________________________________ Address:________________________________________________________________________ City:______________________________ State:_______________ Zip Code:_______________ Phone Number:_______________________ Day of Event Phone Number:________________ Email Address:___________________________________________________________________
I assume full responsibility for any bodily injury, death, or property damage arising from participating in this event. I do hereby for myself, my heirs, personal representatives, successors and assigns, fully acquit and release Edison Festival of Light, Inc. and the City of Fort Myers, including their respective agents, sponsors, employees, officers (hereinafter “Releasees”) from any and all claims, suits, demands, negligence, negligent acts, or causes of action arising from my participation in this event. I further agree to defend, indemnify, and hold harmless the aforementioned Releasees from any loss, liability, or damage arising out of my participation in this event. Photo and Publicity Release: I agree that Edison Festival of Light, Inc. has permission to use my image or likeness from any photographs, drawings, or videos taken during my participation in current and/or future publicity for Festival. I HAVE READ AND UNDERSTOOD THE FOREGOING RELEASE AND INDEMNIFICATION. Printed Name:______________________________________ Signature:_________________________________________ Date:_____________________
For Profit Vendor Fee: $40: PAYABLE: Edison Festival of Light City of Fort Myers Temporary Tax Receipt Application Fee: $10 PAYABLE: City of Ft. Myers $50 Total (For Profit)
Credit Card: Discover____Visa_____MasterCard______ Name on Card:___________________________________ Account Number:________________________________
APPLICATION WILL NOT BE PROCESSED IF IT IS INCOMPLETE.
V-Code:___________ Expiration:___________________
Address Associated with Card:______________________ ______________________________________________ ****PROOF OF INSURANCE IS REQUIRED IF YOU BRING ANY ANIMAL(S). PLEASE CONTACT Holly at (239) 246-0442**** Signature:_________________________________________________________
PARKING DISCLOSURE
DUE TO CONSTRUCTION AT HARBORSIDE EVENT CENTER, THE PARKING LOT CLOSEST TO THIS EVENT IS CURRENTLY CLOSED. PLEASE UTILIZE THE DOWNTOWN PARKING GARAGES. PARKING IN PRIVATELY OWNED LOTS WILL BE AT YOUR OWN RISK, AND YOUR VEHICLE MAY BE TOWED.
