PLEASE PRINT CLEARLY
Name: ___________________________________________________________________________________________
Business Name:___________________________________________________________________________________
Booth Type:_______________________________________________________________________________________
Address:__________________________________________________________________________________________
City: __________________________________________________________________ State: _____ Zip:_______
Phone: (___)__________________________________ Evening Phone: (____) _ ______________________________
Email Address: _______________________________________Cell # (___)__________-________________________
Emergency Contact Name: ____________________________ Phone (___) _________________________________
Payment enclosed is for single space ______
$175.00 Per Single Space approximately 10x10 
$ __________
$ __________ $25.00 Electricity Maximum 20 amps/110 volts $ __________
$ __________ $25.00 Per each additional 20 amps / 110 volts utilized $ __________
$25.00 Late fee for Electrical Hook-up on Fest dates $ __________ $25.00 End Space (approximately 4 – 6 spaces ) $ __________
Total fees enclosed $ __________
$ __________Please send completed application form by June 2nd, 2009 with payment to:
Palos Hills Friendship Festival & Carnival (please make payment to same)
8455 W. 103rd Street, Palos Hills IL. 60465
Release and Indemnity Agreement
I have read all the requirements for application to the 2009 Palos Hills Friendship Festival and I understand that neither
The City of Palos Hills, its employees, agents, officials etc. will be held responsible for any lost, damaged or stolen articles, merchandise, or any other civil liability incurred by me, or any guests or employees within the space set aside for the exhibitor during the set-up, break-down or operating hours of the event. Further, in consideration of the above, the undersigned does hold harmless and agree to indemnify the City of Palos Hills, its employees, agents, officials, and their respective successors and assigns for any damages, claims, losses and expenses, attorney fees, or costs of any legal action resulting from any claims in which they, their members, employees, agents or volunteers are made a party thereto. This Release and Indemnity Agreement is for all matters in connection with the Palos Hills Friendship Festival scheduled for July 10-12th, 2009. Further, I understand that neither The City of Palos Hills, its employees, agents, officials, etc. will be held responsible in any manner for failure of the event to open or to be operable for any reason beyond their control. I understand that the entry fee enclosed with this application is non-refundable upon acceptance.
I have Read, Understand and Agree to this Agreement:
Signed ______________________________________________________________ Date: ________________
.
For Official Use Only
Payment Rec. Date: _______________Booth Space #: __________ Follow Up Sent Date: _____________
