Cruisin’ The Heartland Food Vendor Booth Application Printable Food Vendor ApplicationBooth Name* Name* 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 (Non-Profit booth must submit letter of state exemption and EIN# to receive non-profit rate):* Food 10x10 ($200) Food 10x20 ($225) Food 10x30 ($250) Non-Profit Food 10x10 ($125) Non-Profit Food 10x20 ($150) Non-Profit Food 10x30 ($175) Please describe food that will be sold:*ElectricNOTE: If you do not mark this form properly, we cannot guarantee enough power on event date. If you are uncertain, contact Event Coordinator ASAP. This must be done before submitting application for approval.Do you require electricity?* Yes No How many amps per plug?*(NO MORE THAN ONE 50 AMP, OR ONE 30 AMP AND ONE 20 AMP-NO EXCEPTIONS!)Number of plugs needed and type (see availability below):***THE ONLY PLUGS AVAILABLE ARE:** 20 amp GFC1 receptacles-120V 30 am receptacles-120V 50 amp receptacles-240V These are limited, first come, first served. But you must note on this application to receive. It will not be granted day of if it’s not on this application. NO MORE THAN ONE 50 AMP, OR ONE 30 AMP AND ONE 20 AMP - NO EXCEPTIONS!Exact dimensions of your booth space:*NOTE: THIS IS VERY IMPORTANT AS THE BOOTH LOCATIONS ARE MARKED ACCORDING TO WHAT IS NOTED ON THIS APPLICATION. CHANGES CAN RARELY BE MADE DAY OF SET UP.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 & RegulationsSignature* Reset signature Signature locked. Reset to sign again Online Convenience 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
