Cruisin’ The Heartland Commercial Vendor Booth Application Printable Commercial Vendor ApplicationBooth Name* Contact Person* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Booth type applying for (enter number of spaces needed):For-Profit Commercial/Informational 10x10 Price: $100.00 Quantity: Swap Meet 10x10 Price: $25.00 Quantity: Non-Profit Info Only 10x10 Price: $25.00 Quantity: Non-Profit General Sales/Fundraiser 10x10 Price: $50.00 Quantity: Please describe in detail merchandise to be sold/displayed*Electric Is Not AvailableExact dimensions of your booth space if larger than 10x10:*WAIVER By signing this release and indemnification agreement, we hereby expressly assume all such risks of injury, loss, or damage to us or to any related third party, arising out of or in any way related to the above-described activities, whether or not caused by the act, omission, negligence, or other fault of the City of Elizabethtown, its officers, its employees, or by any other cause. Rules & Regulations Deadline: July 1st, 2019, provided space is still available.Signature* Reset signature Signature locked. Reset to sign again Online Processing Fee (3%)* Price: $0.00 Total $0.00 Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Expiration Date Security Code Cardholder Name
