Corrigin Park Party - 10 December 2021 5.00PM - 7.30PM
Apex Park, Larke St, Corrigin.
Name
First Name
Last Name
Business Name
Short Description of Goods
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Will you be bringing a gazebo?
Yes
No
Stallholders Fee ($10 per stall)
Pay on the Day CASH ONLY
Pay at Corrigin CRC EFT Available
Public Liability Insurance
I will be providing my own Certificate of Currency (Upload below)
I would like to be covered by the Shire of Corrigin's Public Liability
File Upload - Certificate of Currency
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Social Media
Please enter your website and social media handles that we can use in our advertising.
Facebook
Instagram
Website
Other
Signature
Submit
Should be Empty: