Date   

  Your Name  

  Business Name  

  Mailing Address   

  City, State, Zip Code   

  Phone Number    (include area code)

  Email  
Include entire email address, ex:  somebody@somewhere.com

 Health Department Permit #  
Van Buren County Health Department permit is required for registration.  You will receive confirmation of your registration by mail. 

Electric needed?             Voltage:

 Booth requested for what days?  (Check all that apply)
Thursday Evening        Friday          Saturday        Sunday
NOTE:  Due to Hartford's graduation being moved to Sunday, June 10th at 2:30 p.m., we have cancelled our Sunday afternoon Gospel concert for this year, which would have been scheduled for the same day and time.  The biggest crowd days will be Thursday Evening, Friday, and Saturday.  Vendors are welcomed for either or all of these days, but please let us know which days you plan to be at the festival.


Tell us about your services and special requirements:


I understand that by participating in the festival, I take full responsibility for anything that happens to myself or property.  I agree NOT to hold the Hartford Chamber of Commerce, it's members, the City of Hartford, and/or city employees responsible for accidents, loss or damage to myself or property.

_________________________________________________     ____________________
Signature of applicant                                                          Date