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34th Annual Spring Valley Potato Festival

Vendor Registration

Saturday & Sunday, October 1st and 2nd, 2011 

Trade Name                                 __                                                                        

Vendor’s Name                                                                                                                                    

Street Address                                                                                                                                     

City                                                                                                                                                      

State _____________________    Zip ____________________  Phone _______________________________

License Plate Numbers:              Vehicle 1                       Vehicle 2                       Vehicle 3                      

 CATEGORY                

    ____ Arts & Crafts  ____ Farmer’s Market    ____ Public Service

          $ 85.00                   $75.00                        $ 50.00

           *Includes electric

           I am new to the Potato Festival.

            Please assign the same space(s).  They are:                                                                              

            I wish to be moved. I would prefer                                                                                                                                                        

UTILITY REQUIREMENTS                       $ 10.00  fee (each)

____  No electric needed   ____ 110 V-20amp   ____ 220 V                  30 amp                   50 amp                                                                                                              40 amp                     60 amp            100 amp

____ Water hookup                                                                                          

FEES    Space rental fee                                        

Number of spaces   _____     X                                                                                                              

Total Booth Fee                                  _                        ________                                                                                                     

Electric Fee                +          ________                                                                                                          

Total Due                                                     Check Number                                  

**SIGNATURE _____________________________________________________     DATE ____________________________

Make Checks Payable to:

Spring Valley ACTS, Inc.

P.O. Box 26

Spring Valley, OH  45370

**Signature indicates that you have read and agree to abide by all regulations.

 PLEASE LIST ITEMS TO BE SOLD:                                                                                                                        

                                                                                    ___________________________________________________ 

FOOD VENDORS: A CERTIFICATE OF INSURNCE MUST ACCOMPANY THIS APPLICATION.