THE HOLLY RIDGE SAMPLER

2017

APPLICATION FOR PARTICIPATION

Deadline  AUGUST 23

 

Located at the Holly Ridge Vol. Fire Dept.

 

 

109 Holly Street (off Hwy. 17)

 

 

Holly Ridge, NC  28445 
 

SATURDAY,  SEPTEMBER 16

10:00 am - 3:00 pm

 

NAME_____________________________________PH#____________

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NAME OF BOOTH____________________________________________

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ITEMS/PRODUCTS/BUSINESS BEING SHOWCASED__________________

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_________________________________________________________

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EMAIL_____________________________________________________

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ADDRESS_________________________________COUNTY___________

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SPECIAL REQUESTS___________________________________________

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      **(electricity and indoor booths unavailable)

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  *I HAVE READ ALL RULES AND AGREE TO ABIDE BY THEM______________

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HOLD HARMLESS AGREEMENT

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I, ____________________________of____________________________

agree to hold harmless the Holly Ridge Fire Department, it's affiliates, associates, tenants and committee members thereof, from any claim including, but not limited to injury to person, damage to property, loss by fire, theft or any other cause, nor will I/we be a party to any law suit.  This is a legal and binding hold harmless agreement.

Signature__________________________________Date________________

Name of Booth___________________________________________

 

PRINT AND MAIL TO:

 

The Holly Ridge Sampler

c/o B. Longo

 

PO Box 52

Holly Ridge, NC  28445

or

email to:

thehollyridgesampler@gmail.com

Checks payable to:  Holly Ridge Vol. Fire Dept. (see rules)