RIDE TO BETTER HEALTH
A Non-Emergency Medical Transportation Community Health Fair
VENDOR REGISTRATION FORM
Saturday, October 24, 2026 | 9:00 AM - 2:00 PM
CTA Hub & Event Center | 1401 20th Avenue | Gulfport, MS
Vendor Fee: $75 | Limited to 35 Vendors
Thank you for your interest in becoming a vendor. Please complete this form to reserve your vendor space. Your space is not confirmed until registration and payment are received.
SECTION 1 - CONTACT INFORMATION
Contact Name *
*
Business / Organization Name *
*
Email Address*
*
example@example.com
Phone Number *
*
Format: (000) 000-0000.
Business Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Website
Social Media
SECTION 2 - VENDOR INFORMATION
What type of vendor or organization are you? *
*
NEMT/Transportation Provider
Healthcare Provider
Senior Services
Home Health
Assisted Living / Senior Living
Health & Wellness
Mental / Behavioral Health
Pharmacy
Insurance
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Disability Services
Community Organization / Nonprofit
Family Resources
Rehabilitation / Therapy
Medical Equipment / Mobility Services
Other
If Other, please specify:
Please describe the services or resources your organization will provide at the event. *
*
What will you have at your vendor table?
Community Resources / Information
Health Education
Promotional Materials
Giveaways
Health Screening
Demonstrations
Products
Services
Other
Will you be providing a health screening or interactive service?
Yes
No
If yes, please describe:
SECTION 3 - VENDOR SETUP
How many representatives will attend with your organization? *
*
Do you need access to electricity?
Yes
No
Electrical access is subject to venue availability and is not guaranteed.
Will you need a table?
Yes
No
I will provide my own
Will you need chairs?
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Yes
No
I will provide my own
Please list any special accommodations or setup requests.
Optional
SECTION 4 - BUSINESS LOGO
Upload Your Business / Organization Logo
Browse Files
Drag and drop files here
Choose a file
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Please upload a high-quality PNG, JPG, JPEG, or PDF file. Your logo may be used for event marketing, vendor announcements, and promotional materials.
SECTION 5 - VENDOR FEE
Vendor Registration Fee: $75
Your space is not officially reserved until this vendor registration form is completed, the $75 vendor fee is paid, and your registration is confirmed by the event team.
Pay Vendor Fee Here:
CLICK HERE TO MAKE PAYMENT FOR VENDING
Have you submitted your $75 vendor payment?
Yes
Not Yet
Name Used for Square Payment
Enter the name associated with your payment.
SECTION 6 - VENDOR AGREEMENT
I understand that the vendor fee is $75.
I understand that submitting this form without payment does not guarantee my vendor space.
I understand that vendor spaces are limited and available on a first-confirmed basis.
I agree to arrive during the designated vendor setup period.
I agree to keep my vendor area professional, clean, and safe.
I understand that I am responsible for my organization's materials, equipment, products, and personal belongings.
I understand that my business/organization name and logo may be used to promote my participation in Ride to Better Health.
I agree to follow all venue and event guidelines provided before the event.
By signing below, I confirm that the information provided is accurate and that I agree to the vendor requirements for Ride to Better Health.
Signature
*
Date
*
-
Month
-
Day
Year
Date
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SECTION 7 - FINAL CONFIRMATION
How did you hear about Ride to Better Health?
Facebook
Instagram
Event Flyer
Email
Community Organization
Referral
L Harper Healthcare & Transportation Services
Other
Would you like information about sponsorship opportunities?
Yes
No
THANK YOU FOR REGISTERING!
Once both your registration and $75 Square payment have been confirmed, you will receive additional vendor information, including setup instructions and event-day details.
We look forward to having you join us as we move our community toward better health!
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