Vendor Application
Please complete this vendor application and review the event details and vendor agreement provided in the form.
Applicant and Business Information
Business Name
*
Contact Person
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Business Facebook Page
Business Website
Products, Setup, and Booth Details
What products or services will you be selling?
*
Detailed description of the items you plan to sell
*
Select your booth space
*
Please Select
$10 ages 6-17
$35 12 by 12
$50 12 by 24
$75 food truck
Do you need electricity?
*
Yes
No
If needed, what will electricity be used for?
Will you be bringing a pop-up tent?
*
Yes
No
Any special booth requests
Kids Entrepreneurs Section
Are you between the ages of 6-17?
*
Yes
No
Will a parent or guardian be with you the entire time?
*
Yes
No
N/A
If under 18, Are all products homemade?
*
Yes
No
N/A
If under 18, Will an adult over 18 be with the vendor at all times?
*
Yes
No
N/A
Food Truck Compliance and Agreement
If you are registering as a food truck, do you understand that you are responsible for obtaining the required City of Rock Island One-Day Food Vendor/Food Truck Permit?
*
Yes
No
Vendor Agreement
*
I agree to comply with all event rules, safety requirements, and applicable city, county, and state regulations. I understand that I am responsible for obtaining any required permits, licenses, and inspections, including the City of Rock Island One-Day Food Vendor/Food Truck Permit if applicable. I agree to operate only within approved booth or truck spaces, maintain cleanliness, and follow all health and fire safety standards. I understand that failure to comply may result in removal from the event without refund.
Electronic Signature
*
First Name
Middle Name
Last Name
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Rain date will be Monday September 7th.
*
Acknowledged
Payment Collection
Payment instructions: accepted methods include Cash App, Venmo, Apple Pay, and phone card payment details are provided in the form header.
Payment Amount
*
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( X )
USD
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