Wicked Pet Vendor Form 2011

Company Name (required)

Your Name (required)

Email Address(required)

Website

Best phone number to reach you at. (required)

Alternate number. (required)

Street Address (required)

City (required)

State (required)

Zip code (required)

Vendor Fees: select one of the following.*
$35 Non-Profit Booth*$50 booth w/$25 raffle donation**$60 booth w/o raffle donation

*If entering as a non-profit booth, non-profit # required.

Non-Profit Id#

**If donating a raffle item (min. $25 value) please provide a description here.

Raffle Donation

The profits for the booth fees will go toward the Cave Creek Wicked Organization. Please choose your method of payment delivery below. Checks must be written to Cave Creek Wicked.

 I would like to mail my payment in. (must be post-marked by Oct. 7, 2011...) I will drop my payment off at Animal Health Services. (37555 N. Cave Creek Rd)

Disclaimer
I understand that insurance coverage for claims arising out of the operations of vendors, concessions, and exhibitors for this event is not provided. Liability coverage for concessionaires/exhibitors/vendors is available through the Concesssions/Exhibitors and Vendors Program at K & K Insurance Group 1-800-328-2317 or www.kandkinsurance.com and is the responsibility of eaech vendor to obtain if desired.

Sorry no rain dates & registration fees are non-refundable.

By typing your name in the text box below you are stating the above is true to the best of your knowledge and you accept the terms of this form.

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Date: (requried)

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